Provider Demographics
NPI:1649863937
Name:BEAUTY WITHIN HAIR REPLACEMENT CENTER LLC
Entity type:Organization
Organization Name:BEAUTY WITHIN HAIR REPLACEMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NIYETTA
Authorized Official - Middle Name:N
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:HLP, CPS
Authorized Official - Phone:484-640-8036
Mailing Address - Street 1:1650 LIMEKILN PIKE STE B19
Mailing Address - Street 2:
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1503
Mailing Address - Country:US
Mailing Address - Phone:484-640-8036
Mailing Address - Fax:267-633-8881
Practice Address - Street 1:1650 LIMEKILN PIKE STE B19
Practice Address - Street 2:
Practice Address - City:DRESHER
Practice Address - State:PA
Practice Address - Zip Code:19025-1503
Practice Address - Country:US
Practice Address - Phone:267-979-6946
Practice Address - Fax:267-633-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023600467OtherNPI