Provider Demographics
NPI:1063241495
Name:HAIR BUILDERS OF BURLINGTON INC
Entity type:Organization
Organization Name:HAIR BUILDERS OF BURLINGTON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:PERELLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-878-8400
Mailing Address - Street 1:600 BLAIR PARK RD
Mailing Address - Street 2:SUITE 175
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495
Mailing Address - Country:US
Mailing Address - Phone:802-878-8400
Mailing Address - Fax:802-876-7319
Practice Address - Street 1:600 BLAIR PARK RD
Practice Address - Street 2:SUITE 175
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495
Practice Address - Country:US
Practice Address - Phone:802-878-8400
Practice Address - Fax:802-876-7319
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAIR BUILDERS OF BURLINGTON INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies