# IN THE PINK BOUTIQUE, INC.

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

## Provider details

- **NPI number:** 1194140459
- **Authorized official:** MRS. JERI KILLOUGH MILLARD M.S. (CEO)
- **Authorized official phone:** (904) 534-3266

## Contact information

- **Practice address:** 522 3RD ST N, JACKSONVILLE BEACH, FL 32250-7031
- **Practice address phone:** (904) 372-0029
- **Practice address fax:** (904) 372-0063
- **Mailing address:** 522 3RD ST N, JACKSONVILLE BEACH, FL 32250-7031
- **Mailing address phone:** (904) 534-3266
- **Mailing address fax:** (904) 372-0063

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | NONE | NULL | Yes |

## Other

- **Enumeration date:** 02/24/2014
- **Last updated:** 10/18/2023