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General NPI Number Information
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NPI Number | 1003600081
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Entity Type | Organization
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Legal Business Name | HYDRATIONAL BEAUTY SOLUTIONS LLC.
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 409 PARKWAY ST STE G
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City | GREENSBORO
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State | NC
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Zip | 27401-1623
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Country | US
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Telephone | 336-389-1150
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Fax |
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Provider Business Mailing Address
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Address Line | 1633 NEW GARDEN RD
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City | GREENSBORO
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State | NC
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Zip | 27410-2001
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Country | US
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Telephone | 336-327-5120
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MISS TIFFANY JANELLE MILES
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Credential | FNP
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Telephone | 336-327-5120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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