Provider Demographics
NPI:1003600081
Name:HYDRATIONAL BEAUTY SOLUTIONS LLC.
Entity type:Organization
Organization Name:HYDRATIONAL BEAUTY SOLUTIONS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:JANELLE
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:336-327-5120
Mailing Address - Street 1:1633 NEW GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2001
Mailing Address - Country:US
Mailing Address - Phone:336-327-5120
Mailing Address - Fax:
Practice Address - Street 1:409 PARKWAY ST STE G
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1623
Practice Address - Country:US
Practice Address - Phone:336-389-1150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy