Healthcare Provider Details

I. General information

NPI: 1730659491
Provider Name (Legal Business Name): ANOINTED CUTS BARBER & BEAUTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2018
Last Update Date: 11/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 COLUMBIA MALL BLVD STE 189
COLUMBIA SC
29223-7550
US

IV. Provider business mailing address

25 REIDY CT
COLUMBIA SC
29223-8555
US

V. Phone/Fax

Practice location:
  • Phone: 803-477-5243
  • Fax:
Mailing address:
  • Phone: 18034775243
  • Fax:

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. CATHY J MACK
Title or Position: NON-SURGICAL HAIR REPLACEMENT
Credential: HAIR REPLACEMENT
Phone: 803-477-5243