MEDICARE: THE PINK LILY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1487297586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PINK LILY

Provider Business Mailing Address
First Line	:	9704 GEORGETOWN PIKE
Second Line	:
City	:	GREAT FALLS
State	:	VA
Zip	:	22066-2615
Country	:	US
Telephone Number	:	855-746-5545
Fax Number	:

Provider Business Practice Location Address
First Line	:	9704 GEORGETOWN PIKE
Second Line	:
City	:	GREAT FALLS
State	:	VA
Zip	:	22066-2615
Country	:	US
Telephone Number	:	855-746-5545
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	ALEXANDRIA P WEST
Credential	:
Telephone Number	:	855-746-5545

Provider Enumeration Date	:	10/21/2019
Last Update Date	:	10/21/2019

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Directions to “THE PINK LILY ” Practice Location

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