Provider Demographics
NPI:1265186472
Name:SHECOILS HAIR REPLACEMENT & RESTORATION LLC
Entity type:Organization
Organization Name:SHECOILS HAIR REPLACEMENT & RESTORATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HAIR REPLACEMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SHENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-292-5163
Mailing Address - Street 1:4178 PEGWELL AVE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-9279
Mailing Address - Country:US
Mailing Address - Phone:980-292-5163
Mailing Address - Fax:
Practice Address - Street 1:923 UNION ST S
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-5732
Practice Address - Country:US
Practice Address - Phone:980-292-5163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHECOILS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty