Organization
LUXE MEDICAL WIGS LLC
Active
Other names
Luxe Medical, Luxe Medical Cranial Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
DEMAZADA GARY (OWNER/CRANIAL PROTHESIS SPECIALIST)
(470) 606-6050
Entity
Organization
Contact information
Practice address
1609 BLUE RIDGE TER, COLUMBIA, SC 29203-1711
(470) 606-6050
Mailing address
1309 ASHLAND DR, COLUMBIA, SC 29229-8414
(470) 606-6050
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
11/12/2025
Last updated
04/06/2026
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