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
—
Other
Enumeration date
02/24/2014
Last updated
10/18/2023
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