Organization
PINK GLITTER THRIFT BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA JACKSON (PRESIDENT)
(615) 358-7465
Entity
Organization
Contact information
Practice address
3854 DICKERSON PIKE, SUITE C, NASHVILLE, TN 37207-1318
(615) 358-7465
Mailing address
3854 DICKERSON PIKE, SUITE C, NASHVILLE, TN 37207-1318
(615) 358-7465
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
94719
TN
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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