1659439495 NPI number — CHARLOTTE'S HAIR LINE INC.

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 1659439495 NPI number — CHARLOTTE'S HAIR LINE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHARLOTTE'S HAIR LINE INC.
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:
1659439495
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8710 HONEYGO BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PERRY HALL
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21128-9822
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-933-4800
Provider Business Mailing Address Fax Number:
410-933-4803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8710 HONEYGO BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PERRY HALL
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21128-9822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-933-4800
Provider Business Practice Location Address Fax Number:
410-933-4803
Provider Enumeration Date:
12/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TURNER
Authorized Official First Name:
V
Authorized Official Middle Name:
CHARLOTTE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
410-933-4800

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 408803400 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: MJ69CH . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1881400 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 103513 . This is a "JOHNS HOPKINS HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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