Organization
LUXE MEDICAL WIGS LLC
Active
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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