Hairfanatic Boutique LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

HAIRFANATIC BOUTIQUE LLC

Practice address

2757 Laurel St
Suite 3
Columbia, SC 29204-2037

Phone

(803) 730-0231

NPI assigned

Oct 11, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Maranda Brown Davis, CERTIFIED HAIR LOSS

Title

Hair Loss Specialist

Phone

(803) 730-0231

Specialties & licenses 1

Addresses

Tax ID family

Hairfanatic Boutique LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hairfanatic Boutique LLC

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
  • NPI 1205676160
  NPD tax ID

Locations

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1780134965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2757 LAUREL ST",
            "address_2": "SUITE 3",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042037",
            "telephone_number": "803-730-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2757 LAUREL ST",
            "address_2": "SUITE 3",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042037",
            "telephone_number": "803-730-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAIRFANATIC BOUTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MARANDA",
        "authorized_official_middle_name": "BROWN",
        "authorized_official_title_or_position": "HAIR LOSS SPECIALIST",
        "authorized_official_telephone_number": "803-730-0231",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CERTIFIED HAIR LOSS"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hair to Stay LLC.
• Brandi Burgess Hair, BSN, RN
• Nell S Hair, RN BSN CDE
• Lyvian Haire, RBT
• Hairfanatic Boutique LLC
• Victoria Hairston
• G. Jeffrey Haladay, MD
• Jeffrey Hale, RD
• Jeremy Paul Hale, B.S.
• Mary Houts Hale

• Prosthetic/Orthotic Supplier in Columbia, SC
• Providers in Columbia, SC by specialty
• Prosthetic/Orthotic Supplier in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.