Provider Demographics
NPI:1124282405
Name:JAN'S HAIR REPLACEMENT SYSTEMS, INC
Entity type:Organization
Organization Name:JAN'S HAIR REPLACEMENT SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DME
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:H
Authorized Official - Last Name:DOCTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-276-3856
Mailing Address - Street 1:5385 OAKLEY COMMONS BLVD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-7168
Mailing Address - Country:US
Mailing Address - Phone:770-892-3680
Mailing Address - Fax:
Practice Address - Street 1:5385 OAKLEY COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-7168
Practice Address - Country:US
Practice Address - Phone:770-892-3680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies