Provider Demographics
NPI:1477368728
Name:BEVERLY & CO LUXURY HAIR BOUTIQUE
Entity type:Organization
Organization Name:BEVERLY & CO LUXURY HAIR BOUTIQUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS-SAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-721-4546
Mailing Address - Street 1:49 N CENTRAL AVE APT 507
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-3861
Mailing Address - Country:US
Mailing Address - Phone:917-459-7569
Mailing Address - Fax:
Practice Address - Street 1:49 N CENTRAL AVE APT 507
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-3861
Practice Address - Country:US
Practice Address - Phone:917-459-7569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier