Provider Demographics
NPI:1881219616
Name:GLAMMED STUDIO
Entity type:Organization
Organization Name:GLAMMED STUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VASHAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-229-0775
Mailing Address - Street 1:47 BRISTLECONE LN
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-9584
Mailing Address - Country:US
Mailing Address - Phone:803-229-0775
Mailing Address - Fax:
Practice Address - Street 1:47 BRISTLECONE LN
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-9584
Practice Address - Country:US
Practice Address - Phone:803-229-0775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty