Pink Mermaid LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PINK MERMAID LLC

Practice address

1313 Gold Star Hwy
Groton, CT 06340-2717

Phone

(860) 865-0825

Fax

(860) 865-0826

NPI assigned

Dec 6, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Carol Ann Ryall

Title

Mastectomy Fitter

Phone

(860) 865-0825

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1619212362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 GOLD STAR HWY",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063402717",
            "telephone_number": "860-865-0825",
            "fax_number": "860-865-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 GOLD STAR HWY",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063402717",
            "telephone_number": "860-865-0825",
            "fax_number": "860-865-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINK MERMAID LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "RYALL",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MASTECTOMY FITTER",
        "authorized_official_telephone_number": "860-865-0825",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Groton, CT
• Providers in Groton, CT by specialty
• Durable Medical Equipment & Medical Supplies in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.