Provider Demographics
NPI:1366680043
Name:GLC HAIR SYSTEMS LLC
Entity Type:Organization
Organization Name:GLC HAIR SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASTIGLIONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-254-0815
Mailing Address - Street 1:385 CRANBURY RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3000
Mailing Address - Country:US
Mailing Address - Phone:732-254-0815
Mailing Address - Fax:732-254-1269
Practice Address - Street 1:385 CRANBURY RD
Practice Address - Street 2:SUITE 4
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3000
Practice Address - Country:US
Practice Address - Phone:732-254-0815
Practice Address - Fax:732-254-1269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ32WI01036600332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment