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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
JERI KILLOUGH MILLARD (CEO)
(904) 372-0029
Entity
Organization
Contact information
Practice address
3547 HENDRICKS AVE, JACKSONVILLE, FL 32207-5309
(904) 396-5515
(904) 396-5516
Mailing address
3547 HENDRICKS AVE, JACKSONVILLE, FL 32207-5309
(904) 396-5515
(904) 396-5516
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
FL
Other
Enumeration date
06/14/2011
Last updated
01/07/2019
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