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General NPI Number Information
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NPI Number | 1932919545
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Entity Type | Organization
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Legal Business Name | NOUVEAU HAIR AND WIGS LLC
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 107 E MARION AVE
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-2935
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Country | US
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Telephone | 803-426-8092
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Fax |
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Provider Business Mailing Address
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Address Line | 1831 ORIOLE AVE
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3118
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Country | US
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Telephone | 803-426-8092
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALICIA NICOLE LANDRESS
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Credential |
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Telephone | 803-426-8092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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