Milk Moms, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MILK MOMS, INC

Doing business as

Heather's Mastectomy Boutique

Practice address

1714 Bunker Lake Blvd NW Ste 102
Andover, MN 55304-4091

Phone

(763) 314-2004

NPI assigned

Jan 3, 2024

Last updated

Jan 3, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Denzel Uram

Title

Vice President

Phone

(763) 314-2096

Specialties & licenses 1

Addresses

Other names 1

• Heather's Mastectomy Boutique Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Milk Moms, Inc

  • Durable Medical Equipment & Medical Supplies
  • Andover, MN
  • NPI 1306961511

  9335552264

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Heather's Mastectomy Boutique2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Milk Moms, Inc

  • Durable Medical Equipment & Medical Supplies
  • Andover, MN
  • NPI 1306961511
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1710757513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13783 IBIS ST NW STE 200",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553047649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 BUNKER LAKE BLVD NW STE 102",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553044091",
            "telephone_number": "763-314-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILK MOMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "URAM",
        "authorized_official_first_name": "DENZEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "763-314-2096"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heather's Mastectomy Boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allison Merriman, LMFT
• Kendra Mertes, MOTR/L
• Kayla Middendorf, DC
• Rochelle Milbrath, CCC-SLP
• Milk Moms, Inc
• Samantha Nichole Mogen, LICSW
• Nicole Elaine Mold, OTR/L
• Brooke Marie Mollan, LMFT
• Mark Molyneaux, M.A., L.P.C.C.
• Mikayla Money

• Durable Medical Equipment & Medical Supplies in Andover, MN
• Providers in Andover, MN by specialty
• Durable Medical Equipment & Medical Supplies in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.