Provider Demographics
NPI:1326775297
Name:ZOET BEAUTY SUPPLY LLC
Entity Type:Organization
Organization Name:ZOET BEAUTY SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCWHORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-860-3335
Mailing Address - Street 1:1025 VETERANS MEMORIAL HWY SE STE 670
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-7711
Mailing Address - Country:US
Mailing Address - Phone:678-742-8063
Mailing Address - Fax:
Practice Address - Street 1:1025 VETERANS MEMORIAL HWY SE STE 670
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-7711
Practice Address - Country:US
Practice Address - Phone:678-742-8063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier