Provider Demographics
NPI:1083241822
Name:KOSMO BEAUTY INC
Entity Type:Organization
Organization Name:KOSMO BEAUTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAMISHIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BRACKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-204-2186
Mailing Address - Street 1:3275 NE 3RD TER UNIT 1006
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-4554
Mailing Address - Country:US
Mailing Address - Phone:754-204-2186
Mailing Address - Fax:
Practice Address - Street 1:3275 NE 3RD TER UNIT 1006
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-4554
Practice Address - Country:US
Practice Address - Phone:754-204-2186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies