Amt Salon and Hair Replacement Center LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

AMT SALON AND HAIR REPLACEMENT CENTER LLC

Practice address

4039 E Kiehl Ave
Sherwood, AR 72120-3514

Phone

(870) 456-0219

Fax

(501) 285-8949

NPI assigned

Sep 13, 2021

Last updated

Sep 13, 2021By 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

Mr. Adrian TabbNPI 1316780174

Title

Owner

Phone

(870) 456-0219

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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.

• Adrian Tabb

  • Prosthetic/Orthotic Supplier
  • Sherwood, AR
  • NPI 1316780174
  NPD Authorized official

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631491200000",
    "number": "1750050647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4039 E KIEHL AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721203514",
            "telephone_number": "870-456-0219",
            "fax_number": "501-285-8949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4039 E KIEHL AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721203514",
            "telephone_number": "870-456-0219",
            "fax_number": "501-285-8949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMT SALON AND HAIR REPLACEMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A",
        "authorized_official_last_name": "TABB",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-456-0219",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "5012858949",
            "affiliation": "N",
            "endpointDescription": "Fac",
            "address_1": "4039 E Kiehl Ave",
            "city": "Sherwood",
            "state": "AR",
            "country_code": "US",
            "postal_code": "721203514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Sherwood, AR
• Providers in Sherwood, AR by specialty
• Prosthetic/Orthotic Supplier in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.