Provider Demographics
NPI:1710684998
Name:BEYOND BEAUTY HAIR LOSS CLINIC LLC
Entity Type:Organization
Organization Name:BEYOND BEAUTY HAIR LOSS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-281-3536
Mailing Address - Street 1:811 PENDLETON ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3232
Mailing Address - Country:US
Mailing Address - Phone:864-775-4900
Mailing Address - Fax:864-751-4353
Practice Address - Street 1:811 PENDLETON ST STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3209
Practice Address - Country:US
Practice Address - Phone:864-775-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-08
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies