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NPI Code Detail

MEDICARE: MADAME AMUSE BEAUTY RX

MEDICARE: MADAME AMUSE BEAUTY RX
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 : 1912598426
Entity Type Code : Organization
Provider Name (Legal Business Name) : MADAME AMUSE BEAUTY RX
Provider Business Mailing Address
First Line : 4650 N RAINBOW BLVD APT 1219
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-5761
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4650 N RAINBOW BLVD APT 1219
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-5761
Country : US
Telephone Number : 702-688-3250
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MYESHA JAMERSON
Credential :
Telephone Number : 702-688-3250
Provider Enumeration Date : 01/27/2021
Last Update Date : 01/27/2021

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