Hairfanatic Boutique LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

HAIRFANATIC BOUTIQUE LLC

Practice address

2757 Laurel Street Suite 3
Columbia, SC 29204

Phone

(803) 218-9713

NPI assigned

May 29, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Maranda B Davis, HAIRLOSS SPECIALIST

Title

Owner/Specialist-Operator

Phone

(803) 218-9713

Specialties & licenses 1

Addresses

Tax ID family

Hairfanatic Boutique LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hairfanatic Boutique LLC

  • Prosthetic/Orthotic Supplier
  • Columbia, SC
  • NPI 1780134965
  NPD tax ID

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1205676160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2757 LAUREL STREET SUITE 3",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29204",
            "telephone_number": "803-218-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2757 LAUREL STREET SUITE 3",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29204",
            "telephone_number": "803-218-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAIRFANATIC BOUTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MARANDA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/SPECIALIST-OPERATOR",
        "authorized_official_telephone_number": "803-218-9713",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "HAIRLOSS SPECIALIST"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hair Junkie LLC
• Hair to Stay LLC.
• Brandi Burgess Hair, BSN, RN
• Nell S Hair, RN BSN CDE
• Lyvian Haire, RBT
• Hairfanatic Boutique LLC
• Victoria Hairston
• G. Jeffrey Haladay, MD
• Jeffrey Hale, RD
• Jeremy Paul Hale, B.S.

• Durable Medical Equipment & Medical Supplies in Columbia, SC
• Providers in Columbia, SC by specialty
• Durable Medical Equipment & Medical Supplies in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.