Provider Demographics
NPI:1659837797
Name:BLUSH BEAUTY BAR, INC.
Entity Type:Organization
Organization Name:BLUSH BEAUTY BAR, INC.
Other - Org Name:BLUSH BEAUTY HAIR LOSS CENTER, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROTHESIS SPECIALIST/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED HAIRLOSS
Authorized Official - Phone:410-446-2791
Mailing Address - Street 1:1369 WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-1704
Mailing Address - Country:US
Mailing Address - Phone:410-446-2791
Mailing Address - Fax:
Practice Address - Street 1:1214 EUTAW PL STE 2
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-3605
Practice Address - Country:US
Practice Address - Phone:410-446-2791
Practice Address - Fax:667-218-3785
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLUSH BEAUTY BAR, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-13
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty