Organization
H2O HAIR REHAB AND BEAUTY LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA WATERS RC/HLS (OWNER)
(803) 851-3353
Entity
Organization
Contact information
Practice address
208 EASCOTT PL, COLUMBIA, SC 29229-5500
(803) 851-3353
(509) 757-4562
Mailing address
494 MARSH POINTE DR, COLUMBIA, SC 29229-7025
(803) 851-3353
(509) 757-4562
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942848643
—
SC
Enumeration date
04/03/2024
Last updated
04/03/2024
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