Organization
FACETS OF BEAUTY SALON AND BOUTIQUE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAUSHIMA MOORE (BUSINESS ADMINISTRATOR)
(252) 508-6691
Entity
Organization
Contact information
Practice address
122 HARRISON ST, WILLIAMSTON, NC 27892-2464
(252) 508-6691
Mailing address
PO BOX 13, WILLIAMSTON, NC 27892-0013
(252) 508-6691
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922581651
NPI
NC
Enumeration date
09/10/2018
Last updated
05/19/2019
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