Provider Demographics
NPI:1073760153
Name:GETTING GOLDEN TANNING & AJS WIGS
Entity Type:Organization
Organization Name:GETTING GOLDEN TANNING & AJS WIGS
Other - Org Name:AJS WIGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-666-4555
Mailing Address - Street 1:1100 HOOKSETT RD STE 106
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-1073
Mailing Address - Country:US
Mailing Address - Phone:603-666-4555
Mailing Address - Fax:
Practice Address - Street 1:1100 HOOKSETT RD STE 106
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-1073
Practice Address - Country:US
Practice Address - Phone:603-666-4555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies