Organization
HAIR EMPIRE BEAUTY SUPPLY
Active
Other names
Empire Medical Wigs
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABENA OWUSU-ANSAH PHARMD (CHIEF EXECUTIVE OFFICER)
(331) 250-3527
Entity
Organization
Contact information
Practice address
1236 W BOUGHTON RD, BOLINGBROOK, IL 60440-6568
(630) 394-1992
Mailing address
1236 W BOUGHTON RD, BOLINGBROOK, IL 60440-6568
(630) 394-1992
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
11/30/2020
Last updated
03/03/2022
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