Healthcare Provider Details

I. General information

NPI: 1982525200
Provider Name (Legal Business Name): THE CURATED CROWN BOUTIQUE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 GARRISONVILLE RD FL 2
STAFFORD VA
22554-1523
US

IV. Provider business mailing address

147 GARRISONVILLE RD FL 2
STAFFORD VA
22554-1523
US

V. Phone/Fax

Practice location:
  • Phone: 703-300-3124
  • Fax:
Mailing address:
  • Phone: 703-300-3124
  • Fax:

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 Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: SHAAHN WILLIAMS
Title or Position: OWNER
Credential:
Phone: 703-300-3124