Provider Demographics
NPI:1376298240
Name:HAIR AS PRESCRIBED RX LLC
Entity Type:Organization
Organization Name:HAIR AS PRESCRIBED RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:COSMETOLOGIST
Authorized Official - Phone:267-476-2637
Mailing Address - Street 1:124 MORTON AVE # 1045
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:PA
Mailing Address - Zip Code:19033-2521
Mailing Address - Country:US
Mailing Address - Phone:267-476-2637
Mailing Address - Fax:267-550-5038
Practice Address - Street 1:1576 ROOSEVELT DR
Practice Address - Street 2:
Practice Address - City:SHARON HILL
Practice Address - State:PA
Practice Address - Zip Code:19079-2439
Practice Address - Country:US
Practice Address - Phone:267-476-2637
Practice Address - Fax:267-550-5038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier