Provider Demographics
NPI:1659439495
Name:CHARLOTTE'S HAIR LINE INC.
Entity Type:Organization
Organization Name:CHARLOTTE'S HAIR LINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:V
Authorized Official - Middle Name:CHARLOTTE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-933-4800
Mailing Address - Street 1:8710 HONEYGO BLVD
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9822
Mailing Address - Country:US
Mailing Address - Phone:410-933-4800
Mailing Address - Fax:410-933-4803
Practice Address - Street 1:8710 HONEYGO BLVD
Practice Address - Street 2:
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-9822
Practice Address - Country:US
Practice Address - Phone:410-933-4800
Practice Address - Fax:410-933-4803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408803400Medicaid
MDMJ69CHOtherBLUECROSS BLUESHIELD
MD1881400OtherCIGNA
MD103513OtherJOHNS HOPKINS HEALTHCARE
MD103513OtherJOHNS HOPKINS HEALTHCARE
MD1881400OtherCIGNA
MD3871350001Medicare ID - Type Unspecified