Provider Demographics
NPI:1972781045
Name:SHAR'S HAIR LLC
Entity type:Organization
Organization Name:SHAR'S HAIR LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAREATHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-652-6300
Mailing Address - Street 1:8330 NAAB RD STE 130
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1910
Mailing Address - Country:US
Mailing Address - Phone:317-672-9287
Mailing Address - Fax:317-536-3977
Practice Address - Street 1:8330 NAAB RD
Practice Address - Street 2:SUITE 130
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5925
Practice Address - Country:US
Practice Address - Phone:317-672-9287
Practice Address - Fax:317-672-9287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201347210AMedicaid