MEDICARE: THE LUXE HAIR BAR

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	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1760793616	OTHER	GA	NPI

General Provider Information

NPI Number	:	1477097376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE LUXE HAIR BAR

Provider Business Mailing Address
First Line	:	2274 SALEM RD SE
Second Line	:
City	:	CONYERS
State	:	GA
Zip	:	30013-2097
Country	:	US
Telephone Number	:	404-993-0532
Fax Number	:

Provider Business Practice Location Address
First Line	:	2274 SALEM RD SE
Second Line	:	SUITE 106-199
City	:	CONYERS
State	:	GA
Zip	:	30013-2097
Country	:	US
Telephone Number	:	404-993-0532
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SHAKEETA ANN WINFREY
Credential	:	PHD
Telephone Number	:	404-993-0532

Provider Enumeration Date	:	12/12/2016
Last Update Date	:	12/12/2016

Similar Medicare Providers

1467300541 — MILES ABOVE MISSION AWARENESS
Practice Location Address:

2274 SALEM RD SE STE 106-5036
CONYERS, GA
30013-2097

Practice Phone: 404-839-6864
Practice Fax:

1831544881 — MS. ERIKA YOUNG LPC
Practice Location Address:

2274 SALEM RD SE STE 1216
CONYERS, GA
30013-2097

Practice Phone: 678-374-9791
Practice Fax:

1356851547 — MELISSA MORGAN
Practice Location Address:

2274 SALEM RD SE # 106-1048
CONYERS, GA
30013-2097

Practice Phone: 470-796-2175
Practice Fax:

1285285072 — TRESA MORRIS APRN, PMHNP-BC
Practice Location Address:

2274 SALEM RD SE STE 106-1485
CONYERS, GA
30013-2097

Practice Phone: 770-728-9491
Practice Fax:

1437743960 — HOLISTIC COUNSELING AND WELLNESS CENTER LLC
Practice Location Address:

2274 SALEM RD SE # 106-1048
CONYERS, GA
30013-2097

Practice Phone: 404-974-6578
Practice Fax:

1699350835 — TIFFANY MASTIN REGISTERED NURSE
Practice Location Address:

2274 SALEM RD SE STE 1061273
CONYERS, GA
30013-2097

Practice Phone: 844-286-8232
Practice Fax:

Directions to “THE LUXE HAIR BAR ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.