Healthcare Provider Details

I. General information

NPI: 1992618722
Provider Name (Legal Business Name): CROWNE MEDICAL HAIR SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 HILLCREST PKWY STE L PMB 1022
DUBLIN GA
31021
US

IV. Provider business mailing address

1101 HILLCREST PKWY STE L
DUBLIN GA
31021-3581
US

V. Phone/Fax

Practice location:
  • Phone: 478-800-3524
  • Fax: 478-202-9544
Mailing address:
  • Phone: 478-800-3524
  • Fax: 478-202-9544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANETRA DANYELLE HART
Title or Position: CEO
Credential:
Phone: 478-955-9348