Provider Demographics
NPI:1306679600
Name:KSWEETSHAIRCOMPANY
Entity type:Organization
Organization Name:KSWEETSHAIRCOMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAWANZA
Authorized Official - Middle Name:KAMILL
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-285-2243
Mailing Address - Street 1:7457 HUNTERS RUN CT
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-4157
Mailing Address - Country:US
Mailing Address - Phone:469-285-2243
Mailing Address - Fax:
Practice Address - Street 1:921 W OWENS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-2584
Practice Address - Country:US
Practice Address - Phone:469-285-2243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies