Provider Demographics
NPI:1912343989
Name:CULP ENTERPRISES, INC.
Entity Type:Organization
Organization Name:CULP ENTERPRISES, INC.
Other - Org Name:PERMANENT COSMETICS NW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:CULP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-485-1004
Mailing Address - Street 1:81 CENTENNIAL LOOP STE 3
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2471
Mailing Address - Country:US
Mailing Address - Phone:541-485-1004
Mailing Address - Fax:541-342-8491
Practice Address - Street 1:81 CENTENNIAL LOOP STE 3
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2471
Practice Address - Country:US
Practice Address - Phone:541-485-1004
Practice Address - Fax:541-342-8491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORBAP-FA-10155567246ZA2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, MedicalGroup - Single Specialty