Provider Demographics
NPI:1750927430
Name:PINK RIBBON RESOURCE CENTER, INC
Entity type:Organization
Organization Name:PINK RIBBON RESOURCE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:TWINE
Authorized Official - Suffix:
Authorized Official - Credentials:CMF
Authorized Official - Phone:252-207-1802
Mailing Address - Street 1:113 BAXTER LN STE 8
Mailing Address - Street 2:
Mailing Address - City:MOYOCK
Mailing Address - State:NC
Mailing Address - Zip Code:27958-8792
Mailing Address - Country:US
Mailing Address - Phone:252-207-1802
Mailing Address - Fax:
Practice Address - Street 1:113 BAXTER LN STE 8
Practice Address - Street 2:
Practice Address - City:MOYOCK
Practice Address - State:NC
Practice Address - Zip Code:27958-8792
Practice Address - Country:US
Practice Address - Phone:252-207-1802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies