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NPI Code Detail

MEDICARE: SWIM HAIR LLC

MEDICARE: SWIM HAIR 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
1335E00000XProsthetic/Orthotic Supplier

General Provider Information

NPI Number : 1285330571
Entity Type Code : Organization
Provider Name (Legal Business Name) : SWIM HAIR LLC
Provider Business Mailing Address
First Line : 8245 E 96TH ST # 1116
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1013
Country : US
Telephone Number : 317-441-7554
Fax Number :
Provider Business Practice Location Address
First Line : 1856 SOUTHERNWOOD LN
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46231-5210
Country : US
Telephone Number : 317-441-7554
Fax Number :
Authorized Official
Title or Position : CEO
Name : RENADA HARRIS
Credential :
Telephone Number : 317-754-8545
Provider Enumeration Date : 02/07/2023
Last Update Date : 02/07/2023

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Directions to “SWIM HAIR LLC ” Practice Location

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