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THE MASTECTOMY BOUTIQUE
NPI 1124568571
Durable Medical Equipment & Medical Supplies in Marrero, LA

Active since March 06, 2017
4700 WICHERS DR, SUITE 201, MARRERO, LA 70072(504) 758-4220 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 21, 2022, Aug 21, 2017 (2 updates tracked since 2017).

About The Mastectomy Boutique NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE MASTECTOMY BOUTIQUE (NPI 1124568571) is a healthcare organization registered as a durable medical equipment & medical supplies in Marrero, Louisiana and active in the NPI registry since March 2017. The organization lists Iisha K Bailey, Manager, as its authorized official.

NPPES Registry Identity

NPI1124568571
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameLIFELINE HEALTH ESSENTIALS LLC
Location Address4700 WICHERS DR, SUITE 201Marrero, LA 70072-3041
Mailing AddressPo Box 2864Harvey, LA 70059-2864 · (504) 758-4220
Phone(504) 758-4220
Organization SubpartNo
Authorized OfficialIisha K BaileyManager · (504) 758-4220
Enumeration DateMarch 6, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1124568571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedProsthetic/Orthotic SupplierTaxonomy 335E00000X
4700 WICHERS DR, Marrero, LA 70072
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Other Names 1

Doing Business AsThe Mastectomy Boutique

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

The Mastectomy Boutique is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateLouisianaEnrollment IDO20211210001454Non-DME Part B · Mass Immunization (Roster Biller Only)Due dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IMPACT BEHAVIOR HEALTH SERVICES LLC.
Community/Behavioral Health
4700 WICHERS DR, MARRERO SUITE 205B
MARRERO, LA 70072
Jefferson Parish (504) 407-0907
IMPACT BEHAVIORAL
Community/Behavioral Health
4700 WICHERS DR, SUITE 205
MARRERO, LA 70072
Jefferson Parish (504) 407-0709
PRECISION FOOT CARE CENTER, LLC
Podiatrist (Foot & Ankle Surgery)
4700 WICHERS DR, SUITE 204
MARRERO, LA 70072
Jefferson Parish (504) 328-0777
MYRON WALKER
Case Manager/Care Coordinator
4700 WICHERS DR
MARRERO, LA 70072
Jefferson Parish (504) 383-7448
ANGELA SANDERS BRIDGES RSW, MSW
Social Worker
4700 WICHERS DR
MARRERO, LA 70072
Jefferson Parish (504) 319-1769
LINDA KENNEDY
Counselor (Mental Health)
4700 WICHERS DR
MARRERO, LA 70072
Jefferson Parish (504) 304-4097
NICOLE CHRISTMAS
Social Worker
4700 WICHERS DR
MARRERO, LA 70072
Jefferson Parish (504) 383-7448
CHERRELL LYNETTE THOMPSON
Counselor (Addiction (Substance Use Disorder))
4700 WICHERS DR, STE 100
MARRERO, LA 70072
Jefferson Parish (504) 383-7448

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lifeline Health Essentials LLC's NPI number?

The NPI number for Lifeline Health Essentials LLC is 1124568571. It was assigned to this organization in the NPPES registry on March 6, 2017. The provider is doing business as The Mastectomy Boutique.

Where is Lifeline Health Essentials LLC located?

Lifeline Health Essentials LLC is located at 4700 Wichers Dr Suite 201, Marrero, LA 70072. The listed phone number is (504) 758-4220.

What is Lifeline Health Essentials LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Is Lifeline Health Essentials LLC enrolled in Medicare?

Yes. Lifeline Health Essentials LLC is registered in the Medicare PECOS enrollment system.

When is Lifeline Health Essentials LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Louisiana, Mass Immunization (Roster Biller Only)) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

When was this NPI record last updated?

The NPPES record for Lifeline Health Essentials LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.