Provider Demographics
NPI:1366196537
Name:CAMO COLLECTION BEAUTY
Entity type:Organization
Organization Name:CAMO COLLECTION BEAUTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:HAIR PRACTITIONER
Authorized Official - Phone:843-439-1311
Mailing Address - Street 1:605 STATE STREET EXT
Mailing Address - Street 2:
Mailing Address - City:BENNETTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29512-4537
Mailing Address - Country:US
Mailing Address - Phone:843-439-1311
Mailing Address - Fax:843-604-0279
Practice Address - Street 1:605 STATE STREET EXT
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-4537
Practice Address - Country:US
Practice Address - Phone:843-439-1311
Practice Address - Fax:843-602-0279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier