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General NPI Number Information
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NPI Number | 1730016379
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Entity Type | Organization
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Legal Business Name | PURE CROWN COUTURE LLC
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Dates
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Enumeration Date | 05/07/2026
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Last Update Date | 05/07/2026
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Provider Practice Location Address
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Address Line | 2730 PEACHTREE INDUSTRIAL BLVD STE 105
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City | DULUTH
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State | GA
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Zip | 30097-8627
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Country | US
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Telephone | 213-500-0938
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Fax |
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Provider Business Mailing Address
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Address Line | 2730 PEACHTREE INDUSTRIAL BLVD SUITE 105
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City | DULUTH
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State | GA
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Zip | 30097-8626
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Country | US
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Telephone | 213-500-0938
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. KENYA S CAMPBELL
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Credential |
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Telephone | 213-500-0938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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