Healthcare Provider Details

I. General information

NPI: 1710684998
Provider Name (Legal Business Name): BEYOND BEAUTY MEDICAL WIGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2023
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 PENDLETON ST STE B
GREENVILLE SC
29601-3209
US

IV. Provider business mailing address

811 PENDLETON ST STE 2B
GREENVILLE SC
29601-3232
US

V. Phone/Fax

Practice location:
  • Phone: 864-775-4900
  • Fax:
Mailing address:
  • Phone: 864-775-4900
  • Fax: 864-751-4353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ELLISHA DAVIS
Title or Position: OWNER
Credential:
Phone: 404-281-3536