The Pink Door Boutique LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

LC1085182 Issued in MO

Legal business name

THE PINK DOOR BOUTIQUE LLC

Practice address

1623 View Woods Dr
Kirkwood, MO 63122-3522

Phone

(314) 822-8255

NPI assigned

Sep 14, 2010

Organization subpart

No

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

Authorized official

Name

Deirdre Shead

Title

Owner

Phone

(314) 600-1005

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1669780482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 VIEW WOODS DR",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631223522",
            "telephone_number": "314-822-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 VIEW WOODS DR",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631223522",
            "telephone_number": "314-822-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PINK DOOR BOUTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "SHEAD",
        "authorized_official_first_name": "DEIRDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-600-1005"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "LC1085182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Kirkwood, MO
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.