Mart Beauty Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

091855 Issued in VA

Legal business name

MART BEAUTY SUPPLY

Doing business as

Wig Martreflections

Practice address

3031 Peters Creek Rd NW Ste a
Roanoke, VA 24019-2768

Phone

(540) 562-2728

Fax

(540) 562-2764

NPI assigned

Nov 13, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Hilda J. Patterson

Title

President

Phone

(540) 562-2728

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• WIG MARTREFLECTIONS Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114098803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 PETERS CREEK RD NW STE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240192768",
            "telephone_number": "540-562-2728",
            "fax_number": "540-562-2764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 PETERS CREEK RD NW STE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240192768",
            "telephone_number": "540-562-2728",
            "fax_number": "540-562-2764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MART BEAUTY SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "HILDA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-562-2728",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "091855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4670699",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "264475",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "277911",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WIG MARTREFLECTIONS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reilly Paige Marrs
• Dana Alexandra Marsh, BCBA
• Erin Taylor Marsh, PA-C
• Amy Marshall
• Tessley Marshall
• Alexis Martin
• Amanda Len Martin, CRNA
• Amy Stutts Martin, N.P.
• Brittany Ann Martin
• Edgar Martin Jr., RN

• Durable Medical Equipment & Medical Supplies in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Durable Medical Equipment & Medical Supplies in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.