Provider Demographics
NPI:1871315689
Name:MEDCITY LACTATION AND FEEDING SERVICES LLC
Entity type:Organization
Organization Name:MEDCITY LACTATION AND FEEDING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSTAFA
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, IBCLC
Authorized Official - Phone:507-291-9830
Mailing Address - Street 1:4648 CASSIDY RIDGE DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-8431
Mailing Address - Country:US
Mailing Address - Phone:507-291-9830
Mailing Address - Fax:507-291-9824
Practice Address - Street 1:4648 CASSIDY RIDGE DR NE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-8431
Practice Address - Country:US
Practice Address - Phone:507-291-9830
Practice Address - Fax:507-291-9824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty