1093467045 NPI number — PURSUE 2 BEAUTY LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093467045 NPI number — PURSUE 2 BEAUTY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PURSUE 2 BEAUTY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093467045
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7929 EASTERN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21224-2141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-936-4699
Provider Business Mailing Address Fax Number:
443-420-9170

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2122 SUNNYTHORN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLE RIVER
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21220-4923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-936-4699
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/21/2022

Additional Information

Authorized Official

Authorized Official Last Name:
HALL
Authorized Official First Name:
TRACY
Authorized Official Middle Name:
N
Authorized Official Title or Position:
PROSTHETIC / ORTHOTIC SUPPLIER
Authorized Official Telephone Number:
410-936-4699

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 335E00000X . This is a "PROSTHETIC ORTHOTIC PROVIDER" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com