Provider Demographics
NPI:1376099135
Name:POSH DOLLS GLAM LLC
Entity Type:Organization
Organization Name:POSH DOLLS GLAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEPHATARI
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-890-4886
Mailing Address - Street 1:10360 SW 186TH ST
Mailing Address - Street 2:970847
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33197-5001
Mailing Address - Country:US
Mailing Address - Phone:305-890-4886
Mailing Address - Fax:305-909-6450
Practice Address - Street 1:10360 SW 186TH ST
Practice Address - Street 2:970847
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33197-5001
Practice Address - Country:US
Practice Address - Phone:305-890-4886
Practice Address - Fax:305-909-6450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies