Provider Demographics
NPI:1891563029
Name:EMBELLISH BEAUTY CONCEPTS, LLC.
Entity Type:Organization
Organization Name:EMBELLISH BEAUTY CONCEPTS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRANIAL PROSTHETIC SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:VANESSA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-239-8746
Mailing Address - Street 1:533 MARKEL RD
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1120
Mailing Address - Country:US
Mailing Address - Phone:484-239-8746
Mailing Address - Fax:
Practice Address - Street 1:533 MARKEL RD
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1120
Practice Address - Country:US
Practice Address - Phone:484-239-8746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier