Provider Demographics
NPI:1235772435
Name:CRANIAL PROSTHESIS & HAIR LOSS SOLUTIONS LLC
Entity Type:Organization
Organization Name:CRANIAL PROSTHESIS & HAIR LOSS SOLUTIONS LLC
Other - Org Name:YOU AGAIN BOUTIQUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRSTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DRUMEA
Authorized Official - Suffix:
Authorized Official - Credentials:CMF
Authorized Official - Phone:901-417-8928
Mailing Address - Street 1:310 S WALNUT BEND RD STE 12
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7282
Mailing Address - Country:US
Mailing Address - Phone:901-230-7973
Mailing Address - Fax:
Practice Address - Street 1:310 S WALNUT BEND RD STE 12
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7282
Practice Address - Country:US
Practice Address - Phone:901-417-8928
Practice Address - Fax:901-249-6594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty