# PINK RIBBON MASTECTOMY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134110802
- **Authorized official:** MS. DAWN RENEE' HEIDE-MCDOUGALL RFM (PRESIDENT/OWNER)
- **Authorized official phone:** (218) 846-1800

## Contact information

- **Practice address:** 101 GRAYSTONE PLZ, SUITE 200, DETROIT LAKES, MN 56501-3043
- **Practice address phone:** (218) 846-1800
- **Practice address fax:** (218) 846-1803
- **Mailing address:** 101 GRAYSTONE PLZ, SUITE 200, DETROIT LAKES, MN 56501-3043
- **Mailing address phone:** (218) 846-1800
- **Mailing address fax:** (218) 846-1803

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | MN | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 11/02/2005
- **Last updated:** 09/11/2025