Violet M. Deilke

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

CO7557000 Issued in MN

Legal business name

VIOLET M. DEILKE

Doing business as

dba Centre for Hair and Wellness

Practice address

420 Center Ave
Suite #14
Moorhead, MN 56560-1957

Phone

(218) 236-6000

Fax

(218) 284-5889

NPI assigned

Jan 7, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Violet Marlene Deilke, HAIRLOSS SPECIALIST

Title

Owner/Manager

Phone

(218) 236-6000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• dba Centre for Hair and Wellness Doing business as

Locations

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1962687111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 CENTER AVE",
            "address_2": "SUITE #14",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565601957",
            "telephone_number": "218-236-6000",
            "fax_number": "218-284-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 CENTER AVE",
            "address_2": "SUITE #14",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565601957",
            "telephone_number": "218-236-6000",
            "fax_number": "218-284-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIOLET M. DEILKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "DEILKE",
        "authorized_official_first_name": "VIOLET",
        "authorized_official_middle_name": "MARLENE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "218-236-6000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "HAIRLOSS SPECIALIST"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MN",
            "license": "CO7557000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1B4G361CE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Centre for Hair and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Durable Medical Equipment & Medical Supplies in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.