Vanity Lyfe Hairtique

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

VANITY LYFE HAIRTIQUE

Practice address

3309 Ryan St
Lake Charles, LA 70601-8518

Phone

(337) 263-8828

NPI assigned

Oct 23, 2014

Last updated

Oct 23, 2014By 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. Jamika Moore

Title

Owner

Phone

(337) 263-5769

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1386049021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 RYAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018518",
            "telephone_number": "337-263-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3309 RYAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018518",
            "telephone_number": "337-263-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANITY LYFE HAIRTIQUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JAMIKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-263-5769",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Prosthetic/Orthotic Supplier in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.