NPIMap

Organization Active NPI

Hair & Beauty Treatment Center LLC

Doing business as Southern Comfort Medical Supply

  • Prosthetic/Orthotic Supplier
  • Augusta, GA
National Provider Identifier
1285341636
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
HAIR & BEAUTY TREATMENT CENTER LLC
Doing business as
Southern Comfort Medical Supply
Practice address
524 Shartom Dr
Augusta, GA 30907-4751
Phone
(706) 373-9184
Fax
(762) 333-8798
NPI assigned
Nov 3, 2022
Last updated
Nov 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Authorized official

Name
Donecia Perrin-SullivanNPI 1548654411
Title
Owner
Phone
(706) 373-9184

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X NU Primary

Addresses

Primary practice location

524 Shartom Dr
Augusta, GA 30907-4751

Mailing address

524 Shartom Dr
Augusta, GA 30907-4751
Phone (706) 373-9184

Other names 1

  • Southern Comfort Medical Supply Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL simplepractice.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Hair Beauty Treatment Center2 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1285341636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 SHARTOM DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309074751",
            "telephone_number": "706-373-9184",
            "fax_number": "762-333-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 SHARTOM DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309074751",
            "telephone_number": "706-373-9184",
            "fax_number": "762-333-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAIR & BEAUTY TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "PERRIN-SULLIVAN",
        "authorized_official_first_name": "DONECIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-373-9184"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "524 Shartom Dr",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309074751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Southern Comfort Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Comfort Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.