MEDICARE: INSTANT BEAUTY HAIR COLLECTION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1053270439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSTANT BEAUTY HAIR COLLECTION LLC

Provider Business Mailing Address
First Line	:	6 GRAMATAN AVE STE 607
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550-3208
Country	:	US
Telephone Number	:	347-734-8162
Fax Number	:	618-718-7302

Provider Business Practice Location Address
First Line	:	6 GRAMATAN AVE STE 607
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550-3208
Country	:	US
Telephone Number	:	347-734-8162
Fax Number	:	618-718-7302

Authorized Official
Title or Position	:	OWNER
Name	:	JANAY JOHNSON
Credential	:
Telephone Number	:	347-734-8162

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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