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General NPI Number Information
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NPI Number | 1457933319
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Entity Type | Organization
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Legal Business Name | PECULIAR BEAUTY LLC
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Dates
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Enumeration Date | 04/21/2021
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 328 LYNN SHORES DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-2416
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Country | US
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Telephone | 757-917-5642
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Fax |
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Provider Business Mailing Address
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Address Line | 201 STANDARD LN APT 107
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3765
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Country | US
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Telephone | 757-582-3266
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Fax |
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | MS. SHELIA RAMONA BURDEN
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Credential | DME & SUPPLIES
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Telephone | 757-582-3266
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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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