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General NPI Number Information
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NPI Number | 1780547471
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Entity Type | Organization
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Legal Business Name | PHI HAIR LLC
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 5550 MAYFAIR CROSSING DR
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City | LITHONIA
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State | GA
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Zip | 30038-1182
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Country | US
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Telephone | 770-549-5640
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Fax |
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Provider Business Mailing Address
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Address Line | 1445 WOODMONT LN NW STE 1937
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City | ATLANTA
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State | GA
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Zip | 30318-2866
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Country | US
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Telephone | 770-549-5640
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Fax |
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | MS. SHAMILLE PATRICE POWELL
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Credential |
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Telephone | 770-549-5640
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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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