Provider Demographics
NPI:1073953279
Name:COLUMBIA FAMILY BARBER AND BEAUTY
Entity Type:Organization
Organization Name:COLUMBIA FAMILY BARBER AND BEAUTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-414-7280
Mailing Address - Street 1:6500 OLD WATERLOO RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6475
Mailing Address - Country:US
Mailing Address - Phone:410-799-0006
Mailing Address - Fax:
Practice Address - Street 1:6500 OLD WATERLOO RD
Practice Address - Street 2:SUITE 2
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6475
Practice Address - Country:US
Practice Address - Phone:410-799-0006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier