Provider Demographics
NPI:1902551104
Name:COPIOUS HAIR COLLECTION
Entity Type:Organization
Organization Name:COPIOUS HAIR COLLECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-689-3607
Mailing Address - Street 1:4142 OGLETOWN STANTON RD # 142
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4169
Mailing Address - Country:US
Mailing Address - Phone:302-689-3607
Mailing Address - Fax:800-541-3503
Practice Address - Street 1:4142 OGLETOWN STANTON RD # 142
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4169
Practice Address - Country:US
Practice Address - Phone:302-689-3607
Practice Address - Fax:800-541-3503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier