Ejuan Hair Replacement Center

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EJUAN HAIR REPLACEMENT CENTER

Doing business as

Ejuan Hair Replacement Center

Practice address

5043 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2733

Phone

(404) 834-0396

NPI assigned

Sep 9, 2017

Last updated

Sep 14, 2017By 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. Ejuan Davis Smallwood, HLS

Title

Hair Loss Specialist

Phone

(404) 834-0396

Specialties & licenses 4

Addresses

Other names 1

• Ejuan Hair Replacement Center Doing business as

Locations

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.

• Ejuan Davis, HAIR LOSS SPECIALIST

  • Prosthetics Case Management
  • Hiram, GA
  • NPI 1437676244

  Specialist

  NPD (past)

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

{
    "created_epoch": "1504915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505347200000",
    "number": "1528587656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 CENTENNIAL LN",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301320256",
            "telephone_number": "404-834-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5043 JIMMY LEE SMITH PKWY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412733",
            "telephone_number": "404-834-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EJUAN HAIR REPLACEMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-09",
        "last_updated": "2017-09-14",
        "status": "A",
        "authorized_official_last_name": "SMALLWOOD",
        "authorized_official_first_name": "EJUAN",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "HAIR LOSS SPECIALIST",
        "authorized_official_telephone_number": "404-834-0396",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "HLS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "CO097738",
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ejuan Hair Replacement Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ejuan Hair Replacement Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anahid A Ebrahimi, PA-C
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• Timothy Chad Ehmer, DC
• Elite Trio LLC
• Ingrid A Ellison, M.D.
• Benjamin Emareyo
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• Kathleen Elizabeth Empen, M.D.

• Durable Medical Equipment & Medical Supplies in Hiram, GA
• Providers in Hiram, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; 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.