Provider Demographics
NPI:1558533612
Name:FULLER HAIR INC.
Entity Type:Organization
Organization Name:FULLER HAIR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-835-6753
Mailing Address - Street 1:276 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:LANGDON
Mailing Address - State:NH
Mailing Address - Zip Code:03602-8717
Mailing Address - Country:US
Mailing Address - Phone:603-835-6753
Mailing Address - Fax:603-835-8013
Practice Address - Street 1:276 RIVER ST
Practice Address - Street 2:
Practice Address - City:LANGDON
Practice Address - State:NH
Practice Address - Zip Code:03602-8717
Practice Address - Country:US
Practice Address - Phone:603-835-6753
Practice Address - Fax:603-835-8013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment