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General NPI Number Information
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NPI Number | 1962220541
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Entity Type | Organization
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Legal Business Name | PINKSLAYER COMMUNITY OUTREACH
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 3920A BRIDGE RD STE 305
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City | SUFFOLK
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State | VA
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Zip | 23435-1126
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Country | US
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Telephone | 757-240-8127
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 JEFFERSON ST
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City | SUFFOLK
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State | VA
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Zip | 23434-4012
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Country | US
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Telephone | 757-240-8127
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. KRISTIE FIELDS
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Credential | MHS
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Telephone | 757-240-8127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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