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General NPI Number Information
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NPI Number | 1114569290
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Entity Type | Organization
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Legal Business Name | THE LAVISH BEAUTY PALACE, LLC
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Dates
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Enumeration Date | 10/10/2019
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 6701 DEMOCRACY BLVD STE 300
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City | BETHESDA
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State | MD
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Zip | 20817-7500
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Country | US
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Telephone | 844-528-4247
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Fax | 844-528-4247
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Provider Business Mailing Address
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Address Line | 6701 DEMOCRACY BLVD STE 300
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City | BETHESDA
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State | MD
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Zip | 20817-7500
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Country | US
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Telephone | 844-528-4247
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Fax | 844-528-4247
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Authorized Official
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Title or Position | CO FOUNDER
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Name | MRS. VALERIE SHAKESHA PAGE
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Credential |
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Telephone | 844-528-4247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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