Provider Demographics
NPI:1881363851
Name:THE HONEYCOMB HAIR BAR
Entity type:Organization
Organization Name:THE HONEYCOMB HAIR BAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-572-0546
Mailing Address - Street 1:700 BAKER RD STE 113
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1077
Mailing Address - Country:US
Mailing Address - Phone:757-572-0546
Mailing Address - Fax:757-906-3834
Practice Address - Street 1:700 BAKER RD STE 113
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1077
Practice Address - Country:US
Practice Address - Phone:757-572-0546
Practice Address - Fax:757-906-3834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-12
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier