Provider Demographics
NPI:1700079381
Name:SUZANNE HENRI, INC
Entity Type:Organization
Organization Name:SUZANNE HENRI, INC
Other - Org Name:ABSOLUTE PERFECTION BRA-TIQUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:KADAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-352-0233
Mailing Address - Street 1:PO BOX 2399
Mailing Address - Street 2:
Mailing Address - City:APPOMATTOX
Mailing Address - State:VA
Mailing Address - Zip Code:24522-2399
Mailing Address - Country:US
Mailing Address - Phone:434-352-0233
Mailing Address - Fax:434-352-0415
Practice Address - Street 1:839 LEE GRANT AVE
Practice Address - Street 2:
Practice Address - City:APPOMATTOX
Practice Address - State:VA
Practice Address - Zip Code:24522
Practice Address - Country:US
Practice Address - Phone:434-352-0233
Practice Address - Fax:434-352-0415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1700079381Medicare UPIN
VA0665100001Medicare NSC