Exclusive Grooming & Hair Replacement Center

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

C63952 Issued in NC

Legal business name

EXCLUSIVE GROOMING & HAIR REPLACEMENT CENTER

Practice address

1414 Forest Park Dr
Statesville, NC 28677-7925

Phone

(704) 500-1346

NPI assigned

Jun 17, 2010

Last updated

Jun 17, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Diane Sharpe

Title

Owner

Phone

(704) 500-1346

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1366763971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5274",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286875274",
            "telephone_number": "704-500-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 FOREST PARK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286777925",
            "telephone_number": "704-500-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCLUSIVE GROOMING & HAIR REPLACEMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "SHARPE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-500-1346",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NC",
            "license": "C63952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Statesville, NC
• Providers in Statesville, NC by specialty
• Prosthetic/Orthotic Supplier in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; 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.