Provider Demographics
NPI:1982225850
Name:LUXURY LOCS
Entity Type:Organization
Organization Name:LUXURY LOCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-322-3334
Mailing Address - Street 1:4401 W 4TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1006
Mailing Address - Country:US
Mailing Address - Phone:662-322-3334
Mailing Address - Fax:601-557-4329
Practice Address - Street 1:4401 W 4TH ST STE D
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1006
Practice Address - Country:US
Practice Address - Phone:662-322-3334
Practice Address - Fax:601-557-4329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-02
Last Update Date:2020-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier