Provider Demographics
NPI:1124645882
Name:THE ROYAL STICH BY MELINDA
Entity type:Organization
Organization Name:THE ROYAL STICH BY MELINDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-710-9880
Mailing Address - Street 1:8032 BLACK FOREST LN APT 10103
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6746
Mailing Address - Country:US
Mailing Address - Phone:203-710-9880
Mailing Address - Fax:203-710-9880
Practice Address - Street 1:8032 BLACK FOREST LN APT 10103
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6746
Practice Address - Country:US
Practice Address - Phone:203-710-9880
Practice Address - Fax:203-710-9880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier