The Forms Boutique, Inc.

LBN: The Forms Boutique, Inc.
The Forms Boutique, Inc. is an health care organization with primary practice located at 3308 Forest Dr , Columbia SC 29204-4024. The organization recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as the primary health care specialty. The Forms Boutique, Inc. can be contacted via phone (803) 738-8400, or through Mclellan, Amy D. via phone (803) 799-7096.

Contact Information

Primary practice address
3308 Forest Dr Columbia SC 29204-4024
Phone: (803) 738-8400
Fax: (803) 738-8498
Website:
Map and Directions
Authorized official contact:
Name: Mclellan, Amy D. RFM, CMF
Phone: (803) 799-7096

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X

Profile Details

NPI number 1689768376
LBN Legal business name The Forms Boutique, Inc.
DBA Doing business as
Authorized official Mclellan, Amy D. RFM, CMF
Entity Organization
Organization subpart 1 No
Enumeration date Oct 3rd, 2006
Last updated Mar 17th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689768376 NPPES
South Carolina MEDICAID 556570

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