Extension Couture LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

EXTENSION COUTURE LLC

Practice address

17600 W 8 Mile Rd
Southfield, MI 48075-4305

Phone

(248) 973-7340

NPI assigned

Jun 1, 2021

Organization subpart

No

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

Authorized official

Name

Charmaine Bryant

Title

Ceo

Phone

(313) 205-9545

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1992371892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39706",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482390706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17600 W 8 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754305",
            "telephone_number": "248-973-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENSION COUTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "CHARMAINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-205-9545"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Southfield, MI
• Providers in Southfield, MI by specialty
• Customized Equipment (DME) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.