Provider Demographics
NPI:1528879319
Name:EARTHLY BEAUTY LLC
Entity type:Organization
Organization Name:EARTHLY BEAUTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEP
Authorized Official - Prefix:
Authorized Official - First Name:NAKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-719-2077
Mailing Address - Street 1:7509 GARNERS FERRY RD STE G
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-2664
Mailing Address - Country:US
Mailing Address - Phone:803-719-2077
Mailing Address - Fax:
Practice Address - Street 1:7509 GARNERS FERRY RD STE G
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-2664
Practice Address - Country:US
Practice Address - Phone:803-719-2077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment