Provider Demographics
NPI:1598354631
Name:HAIR BY ALLURE
Entity type:Organization
Organization Name:HAIR BY ALLURE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HAIR LOSS SPECIALIST/MASTECTOMY FIT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MILDRED
Authorized Official - Middle Name:ROMAIN
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-313-0320
Mailing Address - Street 1:4658 BOUDINOT ST LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-4521
Mailing Address - Country:US
Mailing Address - Phone:215-313-0320
Mailing Address - Fax:215-324-1903
Practice Address - Street 1:528 W OXFORD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-3696
Practice Address - Country:US
Practice Address - Phone:215-313-0320
Practice Address - Fax:215-324-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty