Healthcare Provider Details

I. General information

NPI: 1225311996
Provider Name (Legal Business Name): PINK RIBBONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6295 SUMMER AVE STE 105
MEMPHIS TN
38134-5983
US

IV. Provider business mailing address

6295 SUMMER AVE STE 105
MEMPHIS TN
38134-5983
US

V. Phone/Fax

Practice location:
  • Phone: 901-417-6060
  • Fax: 901-820-9144
Mailing address:
  • Phone: 901-417-6060
  • Fax: 901-347-2211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateTN

VIII. Authorized Official

Name: SUSAN H TANNER
Title or Position: OWNER
Credential:
Phone: 901-417-6060