Provider Demographics
NPI:1912494683
Name:KACY COSMETICS INC
Entity Type:Organization
Organization Name:KACY COSMETICS INC
Other - Org Name:MERLE NORMAN COSMETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:FUERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-636-1866
Mailing Address - Street 1:2100 SNELLING AVE N STE 72
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-6035
Mailing Address - Country:US
Mailing Address - Phone:651-636-1866
Mailing Address - Fax:
Practice Address - Street 1:2100 SNELLING AVE N STE 72
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-6035
Practice Address - Country:US
Practice Address - Phone:651-636-1866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies