Provider Demographics
NPI:1932919545
Name:NOUVEAU HAIR AND WIGS LLC
Entity type:Organization
Organization Name:NOUVEAU HAIR AND WIGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:LANDRESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-426-8092
Mailing Address - Street 1:1831 ORIOLE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-3118
Mailing Address - Country:US
Mailing Address - Phone:803-426-8092
Mailing Address - Fax:
Practice Address - Street 1:107 E MARION AVE
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-2935
Practice Address - Country:US
Practice Address - Phone:803-426-8092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies