Provider Demographics
NPI:1801378765
Name:NATURALLY HAUTE CHIC LLC
Entity Type:Organization
Organization Name:NATURALLY HAUTE CHIC LLC
Other - Org Name:CHARLESTON CRANIAL PROSTHESIS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEENA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:SPECIALIST
Authorized Official - Phone:843-847-0810
Mailing Address - Street 1:8780 RIVERS AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9257
Mailing Address - Country:US
Mailing Address - Phone:843-847-0810
Mailing Address - Fax:
Practice Address - Street 1:8780 RIVERS AVE STE 104
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9257
Practice Address - Country:US
Practice Address - Phone:843-847-0810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies