Healthcare Provider Details

I. General information

NPI: 1841485570
Provider Name (Legal Business Name): EUPHORIA SALON & DAYSPA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4905 E MAIN ST
AVON IN
46123-9489
US

IV. Provider business mailing address

2645 ONEAL LN BLDG D
BATON ROUGE LA
70816-3187
US

V. Phone/Fax

Practice location:
  • Phone: 317-718-0800
  • Fax: 317-718-8398
Mailing address:
  • Phone: 225-273-1900
  • Fax: 225-273-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PHYLLIS SALES
Title or Position: PRESIDENT
Credential:
Phone: 225-273-1900