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NPI Code Detail

MEDICARE: LL HAIR CENTER, LLC

MEDICARE: LL HAIR CENTER, 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
1332B00000XDurable Medical Equipment & Medical SuppliesG62-03919NV

General Provider Information

NPI Number : 1588043988
Entity Type Code : Organization
Provider Name (Legal Business Name) : LL HAIR CENTER, LLC
Provider Business Mailing Address
First Line : 1010 E SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-3218
Country : US
Telephone Number : 702-737-5759
Fax Number : 702-737-8203
Provider Business Practice Location Address
First Line : 1010 E SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-3218
Country : US
Telephone Number : 702-737-5759
Fax Number : 702-737-8203
Authorized Official
Title or Position : MANAGER
Name : SCOTT OLIVER HEATON
Credential :
Telephone Number : 702-737-5759
Provider Enumeration Date : 05/19/2015
Last Update Date : 05/19/2015

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Directions to “LL HAIR CENTER, LLC ” Practice Location

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