Provider Demographics
NPI:1023523263
Name:LOTUS HAIR RESTORATION LLC BEAUTY WITHIN HAIR LOSS AND RESTORATION
Entity type:Organization
Organization Name:LOTUS HAIR RESTORATION LLC BEAUTY WITHIN HAIR LOSS AND RESTORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-459-3062
Mailing Address - Street 1:9618 INVERARY CT
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1911
Mailing Address - Country:US
Mailing Address - Phone:240-459-3062
Mailing Address - Fax:
Practice Address - Street 1:7127 ALLENTOWN RD STE 205
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-1523
Practice Address - Country:US
Practice Address - Phone:240-459-3062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies