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General NPI Number Information
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NPI Number | 1093932717
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Entity Type | Organization
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Legal Business Name | BEYOND PINK, LLC
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 04/11/2013
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Provider Practice Location Address
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Address Line | 501 ALTA VISTA ST
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City | ALTA
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State | IA
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Zip | 51002-1437
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Country | US
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Telephone | 712-200-3879
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Fax | 877-475-2403
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Provider Business Mailing Address
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Address Line | 501 ALTA VISTA ST
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City | ALTA
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State | IA
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Zip | 51002-1437
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Country | US
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Telephone | 712-200-3879
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Fax | 877-475-2403
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Authorized Official
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Title or Position | OWNER
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Name | MS. KIM WEILAND
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Credential | BSN, RNC, CFM
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Telephone | 712-200-3879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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