Provider Demographics
NPI:1104546134
Name:BEAUTIFUL REZILIENCE HAIR RESTORATION LLC
Entity type:Organization
Organization Name:BEAUTIFUL REZILIENCE HAIR RESTORATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZAHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-258-3588
Mailing Address - Street 1:1305 ALLEN RIDGE DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-0127
Mailing Address - Country:US
Mailing Address - Phone:252-258-3588
Mailing Address - Fax:
Practice Address - Street 1:807 RED BANKS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5834
Practice Address - Country:US
Practice Address - Phone:252-258-3588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies