Provider Demographics
NPI:1215215876
Name:SILHOUETTE ENTERPRISES
Entity Type:Organization
Organization Name:SILHOUETTE ENTERPRISES
Other - Org Name:SILHOUETTES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:BELL
Authorized Official - Last Name:GATWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:CFM
Authorized Official - Phone:828-327-3344
Mailing Address - Street 1:1239 2ND ST NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2660
Mailing Address - Country:US
Mailing Address - Phone:828-327-3344
Mailing Address - Fax:828-327-3834
Practice Address - Street 1:909 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677
Practice Address - Country:US
Practice Address - Phone:704-873-0991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SILHOUETTE ENTERPRISES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1174530364OtherNPI
NC7704431Medicaid
NC1174530364OtherNPI