Organization · NPI-2

Ada Leroux Hair, LLC

Specialist · Lawrenceville, GA

NPI number1134879026

StatusActive

Last updated in NPPESJul 22, 2022

Details

NPI: 1134879026
Entity type: Organization (NPI-2)
Legal business name: Ada Leroux Hair, LLC
Organization subpart: No
Enumeration date: Mar 24, 2022
Certification date: Jul 13, 2022
Last updated: Jul 22, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
174400000X	Specialist	–	–	Yes
335E00000X	Prosthetic/Orthotic Supplier	–	–
332B00000X	Durable Medical Equipment & Medical Supplies	–	–
332BC3200X	Durable Medical Equipment & Medical Supplies, Customized Equipment	–	–

Practice location

1755 N Brown Rd
Ste 200
Lawrenceville, GA 30043

Phone 678-787-6848 · Fax 678-820-7965

Mailing address

1755 N Brown Rd
Ste 200
Lawrenceville, GA 30043

Phone 678-787-6848 · Fax 678-820-7965

Authorized official

Germaine Leroux
Ceo
6787876848

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