Provider Demographics
NPI:1326727926
Name:CROWNED BY DANA'S MEDICAL WIGS LLC
Entity Type:Organization
Organization Name:CROWNED BY DANA'S MEDICAL WIGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNCH
Authorized Official - Suffix:
Authorized Official - Credentials:LIC BARBER
Authorized Official - Phone:504-427-4570
Mailing Address - Street 1:618 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-1229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:618 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-1229
Practice Address - Country:US
Practice Address - Phone:504-341-6777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies