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General NPI Number Information
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NPI Number | 1275681595
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Entity Type | Organization
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Legal Business Name | LOVE WIGS, INC.
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 555A N MICHIGAN AVE
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City | KENILWORTH
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State | NJ
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Zip | 07033-1076
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Country | US
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Telephone | 800-526-7627
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Fax | 908-687-9509
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Provider Business Mailing Address
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Address Line | 555A N MICHIGAN AVE
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City | KENILWORTH
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State | NJ
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Zip | 07033-1076
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Country | US
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Telephone | 800-526-7627
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Fax | 908-687-9509
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT ANTHONY ANZIVINO
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Credential |
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Telephone | 800-526-7627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State | NJ
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