Queen of Hearts Cosmetics

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

QUEEN OF HEARTS COSMETICS

Practice address

4019 Rhyne Cir SE
Smyrna, GA 30082-4248

Phone

(201) 936-0966

NPI assigned

Aug 1, 2022

Last updated

Aug 4, 2022By 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

Charese Nicole Mainor

Title

Cranial Prosthesis Specialist

Phone

(201) 936-0966

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1942937958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4019 RHYNE CIR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300824248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4019 RHYNE CIR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300824248",
            "telephone_number": "201-936-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEEN OF HEARTS COSMETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "MAINOR",
        "authorized_official_first_name": "CHARESE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "CRANIAL PROSTHESIS SPECIALIST",
        "authorized_official_telephone_number": "201-936-0966"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Prosthetic/Orthotic Supplier in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.