Healthcare Provider Details

I. General information

NPI: 1457161036
Provider Name (Legal Business Name): SALON SC L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 BRADDOCK AVE
BRADDOCK PA
15104
US

IV. Provider business mailing address

124 LANFORD DR
PITTSBURGH PA
15235-1856
US

V. Phone/Fax

Practice location:
  • Phone: 412-727-7689
  • Fax: 412-727-7852
Mailing address:
  • Phone: 412-727-7689
  • Fax: 412-727-7852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. SHANNA COCHRAN
Title or Position: OWNER
Credential:
Phone: 412-727-7689