Organization Name: | THE PINK DOOR BOUTIQUE LLC |
NPI Number: | 1669780482 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEIRDRE SHEAD (OWNER) |
Mailing Address: | 1623 View Woods Dr Kirkwood |
State: | MO US |
Postal Code: | 631223522 |
Phone Number: | 3148228255 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2010 |
NPI Last Update Date: | 09/14/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | LC1085182 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |