Healthcare Provider Details

I. General information

NPI: 1508786047
Provider Name (Legal Business Name): GENESIS HAIR SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2056 TWEED DR
ACWORTH GA
30101-3632
US

IV. Provider business mailing address

3344 COBB PKWY NW STE 200
ACWORTH GA
30101-8345
US

V. Phone/Fax

Practice location:
  • Phone: 678-468-1739
  • Fax:
Mailing address:
  • Phone: 678-468-1739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: HALIMA YAMAH
Title or Position: MANAGING MEMBER
Credential:
Phone: 678-468-1739