Organization
MASTECTOMY SHOPPE, LLC
Active
Other names
Pink Ribbon Gals
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTEN E TESE (MANAGING MEMBER)
(561) 573-9596
Entity
Organization
Contact information
Practice address
9700 REDSTONE DR STE 200, INDIAN LAND, SC 29707-5409
(803) 548-8627
(803) 548-8630
Mailing address
9700 REDSTONE DR STE 200, INDIAN LAND, SC 29707-5409
(803) 548-8627
(803) 548-8630
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/02/2021
Last updated
03/31/2022
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