Provider Demographics
NPI:1154740595
Name:THE MILK FAIRY
Entity type:Organization
Organization Name:THE MILK FAIRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:POOTS
Authorized Official - Last Name:REMINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:CLC, CBS
Authorized Official - Phone:434-242-7563
Mailing Address - Street 1:2547 FRAYS MILL RD
Mailing Address - Street 2:
Mailing Address - City:RUCKERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22968-1612
Mailing Address - Country:US
Mailing Address - Phone:434-242-7563
Mailing Address - Fax:
Practice Address - Street 1:2547 FRAYS MILL RD
Practice Address - Street 2:
Practice Address - City:RUCKERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22968-1612
Practice Address - Country:US
Practice Address - Phone:434-242-7563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty