The Glam Pass Inc.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

THE GLAM PASS INC.

Doing business as

Simply Wiggin' It

Practice address

9455 103Rd St Apt 613
Jacksonville, FL 32210-9273

Phone

(305) 494-6608

NPI assigned

Nov 13, 2020

Last updated

Nov 13, 2020By 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

Kyla R Rogers

Title

Owner

Phone

(305) 494-6608

Specialties & licenses 1

Addresses

Other names 1

• Simply Wiggin' It Doing business as

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1720680838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9455 103RD ST APT 613",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322109273",
            "telephone_number": "305-494-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9455 103RD ST APT 613",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322109273",
            "telephone_number": "305-494-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GLAM PASS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "KYLA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-494-6608"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Simply Wiggin' It",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Customized Equipment (DME) in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Customized Equipment (DME) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.