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General NPI Number Information
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NPI Number | 1619489390
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Entity Type | Organization
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Legal Business Name | BREAST CANCER BREAST CARE PRODUCTS, LLC DBA PINK RIBBON CONSULTING
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Dates
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Enumeration Date | 11/02/2017
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Last Update Date | 11/02/2017
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Provider Practice Location Address
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Address Line | 55 SADDLEVIEW RUN
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City | ATLANTA
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State | GA
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Zip | 30350
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Country | US
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Telephone | 404-579-7738
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Fax |
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Provider Business Mailing Address
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Address Line | 55 SADDLEVIEW RUN
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City | ATLANTA
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State | GA
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Zip | 30350
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Country | US
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Telephone | 404-579-7738
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BETTY S ALTERMAN
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Credential | BOC
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Telephone | 404-579-7738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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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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