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BIRCH BOUTIQUE LLC
NPI 1154045888
Mastectomy Fitter in Antigo, WI

Active since September 27, 2022
612 CLEMONT ST, STE #8, ANTIGO, WI 54409(715) 350-7174(715) 716-4330 Get Directions Write a Review

NPPES record last updated: February 29, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Birch Boutique Llc NPPES

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

BIRCH BOUTIQUE LLC (NPI 1154045888) is a healthcare organization registered as a mastectomy fitter in Antigo, Wisconsin and active in the NPI registry since September 2022. The organization lists Greta Tomany, Owner, as its authorized official.

NPPES Registry Identity

NPI1154045888
Entity TypeOrganization
Primary Taxonomy224900000X
Legal Business NameBIRCH BOUTIQUE LLC
Location Address612 CLEMONT ST, STE #8Antigo, WI 54409-1988
Mailing Address612 Clemont St, Ste #8Antigo, WI 54409-1988 · (715) 350-7174 · Fax (715) 716-4330
Phone(715) 350-7174
Fax(715) 716-4330
Organization SubpartNo
Authorized OfficialGreta TomanyOwner · (715) 350-7174
Enumeration DateSeptember 27, 2022
Last NPPES UpdateFebruary 29, 2024
NPPES CertifiedFebruary 29, 2024
✔ NPI 1154045888 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMastectomy FitterRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code224900000X
Definition
An individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
612 CLEMONT ST, Antigo, WI 54409
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Medical Equipment Supplier Medicare DMEPOS

Medicare supplier enrollment and the product categories Birch Boutique, LLC carries, from the Medicare DMEPOS supplier directory.

Birch Boutique, LLC

DMEPOS supplier · Antigo, WI
✔

Accepts Medicare assignment

Birch Boutique, LLC agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)23281027
Medicare Participant SinceDecember 14, 2023
Supplier Location612 Clermont St Ste 8Antigo, WI 54409
Phone(715) 350-7174
Supplier Specialties
Medical Supply Company Other

Medicare Product Categories

Breast Prostheses and/or Accessories
Prosthetic bra, Surgical bra
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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 Birch Boutique LLC's NPI number?

The NPI number for Birch Boutique LLC is 1154045888. It was assigned to this organization in the NPPES registry on September 27, 2022.

Where is Birch Boutique LLC located?

Birch Boutique LLC is located at 612 Clemont St Ste #8, Antigo, WI 54409. The listed phone number is (715) 350-7174.

What is Birch Boutique LLC's specialty?

The primary specialty registered for this NPI is Mastectomy Fitter with taxonomy code 224900000X.

Does Birch Boutique LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Birch Boutique, LLC accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

When was this NPI record last updated?

The NPPES record for Birch Boutique LLC was last updated on February 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.