Provider Demographics
NPI:1942671094
Name:SALON RX, LLC
Entity Type:Organization
Organization Name:SALON RX, LLC
Other - Org Name:HOUSTON MONT CLAIRE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:DELORES
Authorized Official - Last Name:MCCREA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-583-5273
Mailing Address - Street 1:4306 COOK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63113-2808
Mailing Address - Country:US
Mailing Address - Phone:314-583-5273
Mailing Address - Fax:
Practice Address - Street 1:4306 COOK AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63113-2808
Practice Address - Country:US
Practice Address - Phone:314-583-5273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC1339704332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies