Provider Demographics
NPI:1871316570
Name:EC HAIR MEDIC LLC
Entity type:Organization
Organization Name:EC HAIR MEDIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRANIAL PROSTHESIS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASKEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-887-7286
Mailing Address - Street 1:440 US HIGHWAY 70 W
Mailing Address - Street 2:
Mailing Address - City:HAVELOCK
Mailing Address - State:NC
Mailing Address - Zip Code:28532-9509
Mailing Address - Country:US
Mailing Address - Phone:203-887-7286
Mailing Address - Fax:
Practice Address - Street 1:440 US HIGHWAY 70 W
Practice Address - Street 2:
Practice Address - City:HAVELOCK
Practice Address - State:NC
Practice Address - Zip Code:28532-9509
Practice Address - Country:US
Practice Address - Phone:203-887-7286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-02
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier