Provider Demographics
NPI:1871251272
Name:EMBELLISHED BEAUTY BRANDS LLC
Entity Type:Organization
Organization Name:EMBELLISHED BEAUTY BRANDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIOUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-771-8543
Mailing Address - Street 1:3277 SUMMIT GLEN DR
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-5398
Mailing Address - Country:US
Mailing Address - Phone:140-477-1854
Mailing Address - Fax:
Practice Address - Street 1:3277 SUMMIT GLEN DR
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-5398
Practice Address - Country:US
Practice Address - Phone:140-477-1854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier