Healthcare Provider Details

I. General information

NPI: 1891451316
Provider Name (Legal Business Name): GLOBAL SALONLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 11/15/2021
Certification Date: 11/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 MIAMISBURG CENTERVILLE RD
DAYTON OH
45459-3738
US

IV. Provider business mailing address

10748 CREEK STONE CT
DAYTON OH
45458-4741
US

V. Phone/Fax

Practice location:
  • Phone: 937-433-4777
  • Fax:
Mailing address:
  • Phone: 937-241-0271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARLO BAKER
Title or Position: CEO
Credential:
Phone: 937-241-0271