Healthcare Provider Details

I. General information

NPI: 1104737444
Provider Name (Legal Business Name): HARRIS MEDICAL HAIR SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W WOODLAWN RD STE D
CHARLOTTE NC
28217-2174
US

IV. Provider business mailing address

2120 N BREVARD ST APT 213
CHARLOTTE NC
28206-3655
US

V. Phone/Fax

Practice location:
  • Phone: 716-319-4842
  • Fax:
Mailing address:
  • Phone: 716-319-4842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: DELEEAH HARRIS
Title or Position: OWNER
Credential:
Phone: 716-319-4842