Provider Demographics
NPI:1093467045
Name:PURSUE 2 BEAUTY LLC
Entity Type:Organization
Organization Name:PURSUE 2 BEAUTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROSTHETIC / ORTHOTIC SUPPLIER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:N
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-936-4699
Mailing Address - Street 1:7929 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2141
Mailing Address - Country:US
Mailing Address - Phone:410-936-4699
Mailing Address - Fax:443-420-9170
Practice Address - Street 1:2122 SUNNYTHORN RD
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-4923
Practice Address - Country:US
Practice Address - Phone:410-936-4699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
335E00000XOtherPROSTHETIC ORTHOTIC PROVIDER