The Pink Boutique

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0105777 Issued in TX

Legal business name

THE PINK BOUTIQUE

Practice address

7410 John Smith
Ste 210
San Antonio, TX 78229-4421

Phone

(210) 614-3804

Fax

(210) 614-3805

NPI assigned

Jul 23, 2015

Organization subpart

Yes

Parent organization

BEXAR CARE HOME MEDICAL EQUIPMENT & SUPPLY,LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Alicia Correa, RN CMFNPI 1114207818

Title

Ceo

Phone

(210) 614-3804

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Bexar Care Home Medical Equipment and Supply LLC2 organizations share this tax ID, including this one

Part of

Bexar Care Home Medical Equipment and Supply LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bexar Care Home Medical Equipment and Supply, LLC

  • Oxygen Equipment & Supplies (DME)
  • San Antonio, TX
  • NPI 1609854447
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Bexar Care Home Medical Equipment and Supply, LLC

  • Oxygen Equipment & Supplies (DME)
  • San Antonio, TX
  • NPI 1609854447
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alicia G Correa, ATP

  • Other Technician
  • San Antonio, TX
  • NPI 1114207818
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1194100800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29366",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782290366",
            "telephone_number": "210-614-3804",
            "fax_number": "210-614-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7410 JOHN SMITH",
            "address_2": "STE 210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294421",
            "telephone_number": "210-614-3804",
            "fax_number": "210-614-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PINK BOUTIQUE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEXAR CARE HOME MEDICAL EQUIPMENT & SUPPLY,LLC",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "CORREA",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "210-614-3804",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN CMF"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0105777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016486501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.