| Organization Name: | THE GOLDEN ROSE WIG SHOPPE |
| NPI Number: | 1477989416 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SANDRA JUNE GENDRON (PROPRIETOR/LICENSED COSMETOLOGIST) |
| Mailing Address: | 663 Oaklawn Ave Cranston |
| State: | RI US |
| Postal Code: | 029203829 |
| Phone Number: | 4019467673 |
| Fax Number: | 4019467674 |
| NPI Enumeration Date: | 09/23/2013 |
| NPI Last Update Date: | 09/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | HI06907 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |