1. Home
  2. Directory
  3. Alabama
  4. Montgomery
  5. Mastectomy Fitter
  6. NPI Profile

PREMIER MASTECTOMY VENDOR LLC
NPI 1699458380
Mastectomy Fitter in Montgomery, AL

Active since August 09, 2023
5911 MONTICELLO DR STE B, MONTGOMERY, AL 36117(629) 279-5720 Get Directions Write a Review

NPPES record last updated: December 20, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Premier Mastectomy Vendor Llc NPPES

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

PREMIER MASTECTOMY VENDOR LLC (NPI 1699458380) is a healthcare organization registered as a mastectomy fitter in Montgomery, Alabama and active in the NPI registry since August 2023. The organization lists Jasmine Bean, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1699458380
Entity TypeOrganization
Primary Taxonomy224900000X
Legal Business NamePREMIER MASTECTOMY VENDOR LLC
Location Address5911 MONTICELLO DR STE BMontgomery, AL 36117-1940
Mailing Address5911 Monticello Dr Ste BMontgomery, AL 36117-1940 · (629) 279-5720
Phone(629) 279-5720
Organization SubpartNo
Authorized OfficialJasmine BeanCo-owner · (629) 279-5270
Enumeration DateAugust 9, 2023
Last NPPES UpdateDecember 20, 2023
NPPES CertifiedDecember 20, 2023
✔ NPI 1699458380 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 ListedMassage TherapistTaxonomy 225700000X
5911 MONTICELLO DR STE B, Montgomery, AL 36117
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

MRS. JASMINE GRAHAM BSHA, CFM
Mastectomy Fitter
5911 MONTICELLO DR STE B
MONTGOMERY, AL 36117
Montgomery County (334) 676-2797

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 Premier Mastectomy Vendor LLC's NPI number?

The NPI number for Premier Mastectomy Vendor LLC is 1699458380. It was assigned to this organization in the NPPES registry on August 9, 2023.

Where is Premier Mastectomy Vendor LLC located?

Premier Mastectomy Vendor LLC is located at 5911 Monticello Dr Ste B, Montgomery, AL 36117. The listed phone number is (629) 279-5720.

What is Premier Mastectomy Vendor LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Premier Mastectomy Vendor LLC was last updated on December 20, 2023. 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.