Provider Demographics
NPI:1205028073
Name:NBS LLC
Entity Type:Organization
Organization Name:NBS LLC
Other - Org Name:MADELINE'S HAIR REPLACEMENT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:B
Authorized Official - Last Name:STAPLES
Authorized Official - Suffix:
Authorized Official - Credentials:COSMETOLOGIST
Authorized Official - Phone:207-571-3277
Mailing Address - Street 1:3 EASTVIEW PKWY STE 1
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-6701
Mailing Address - Country:US
Mailing Address - Phone:207-571-3277
Mailing Address - Fax:207-571-3278
Practice Address - Street 1:3 EASTVIEW PKWY STE 1
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-6701
Practice Address - Country:US
Practice Address - Phone:207-571-3277
Practice Address - Fax:207-571-3278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECO43637332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0804460001Medicare NSC