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Organization
IN THE PINK BOUTIQUE, INC.
Active
Organization
IN THE PINK BOUTIQUE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JERI KILLOUGH MILLARD M.S. (CEO)
(904) 534-3266
Entity
Organization
Contact information
Practice address
522 3RD ST N, JACKSONVILLE BEACH, FL 32250-7031
(904) 372-0029
(904) 372-0063
Mailing address
522 3RD ST N, JACKSONVILLE BEACH, FL 32250-7031
(904) 534-3266
(904) 372-0063
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
NONE
NULL
Other
Enumeration date
02/24/2014
Last updated
10/18/2023
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