MEDICARE: PURE CROWN COUTURE 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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1730016379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURE CROWN COUTURE LLC

Provider Business Mailing Address
First Line	:	2730 PEACHTREE INDUSTRIAL BLVD
Second Line	:	SUITE 105
City	:	DULUTH
State	:	GA
Zip	:	30097-8626
Country	:	US
Telephone Number	:	213-500-0938
Fax Number	:

Provider Business Practice Location Address
First Line	:	2730 PEACHTREE INDUSTRIAL BLVD STE 105
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30097-8627
Country	:	US
Telephone Number	:	213-500-0938
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. KENYA S CAMPBELL
Credential	:
Telephone Number	:	213-500-0938

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

Similar Medicare Providers

1992955736 — DR. PURNIMA BANSAL M.D.
Practice Location Address:

2730 PEACHTREE INDUSTRIAL BLVD STE 105
DULUTH, GA
30097-8627

Practice Phone: 404-490-0754
Practice Fax: 678-712-4389

1891177382 — DR. SOOL KEE SONG MD
Practice Location Address:

2730 PEACHTREE INDUSTRIAL BLVD STE 101
DULUTH, GA
30097-8627

Practice Phone: 404-548-8850
Practice Fax:

1386326981 — KISHA NICOLE GARNER NP
Practice Location Address:

2730 PEACHTREE INDUSTRIAL BLVD STE 105
DULUTH, GA
30097-8627

Practice Phone: 404-786-3845
Practice Fax:

1750064515 — MS. MARQUITA KATRICE THOMAS CPT
Practice Location Address:

2730 PEACHTREE INDUSTRIAL BLVD STE 105
DULUTH, GA
30097-8627

Practice Phone: 678-476-2060
Practice Fax:

1801631247 — PIB FAMILY MEDICINE
Practice Location Address:

2730 PEACHTREE INDUSTRIAL BLVD STE 101
DULUTH, GA
30097-8627

Practice Phone: 404-548-8850
Practice Fax:

1386594836 — PRINCESS SAMARRA WISE APRN, FNP-BC
Practice Location Address:

2730 PEACHTREE INDUSTRIAL BLVD STE 105
DULUTH, GA
30097-8627

Practice Phone: 770-600-2458
Practice Fax: 770-600-2459

Directions to “PURE CROWN COUTURE LLC ” 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.