# HEAD QUARTERS CUSTOM HAIR DESIGN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992473441
- **Authorized official:** MS. ZANDRA MOORE (OWNER)
- **Authorized official phone:** (850) 816-0122

## Contact information

- **Practice address:** 948 S HIGHWAY 29, CANTONMENT, FL 32533-6416
- **Practice address phone:** (850) 816-0122
- **Mailing address:** 8301 RANGER DR, PENSACOLA, FL 32534-3504
- **Mailing address phone:** (850) 816-0122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 08/31/2021
- **Last updated:** 08/31/2021