Healthcare Provider Details

I. General information

NPI: 1336378728
Provider Name (Legal Business Name): P3 NUTRITIONALS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WHITE HORSE RD SUITE 902
VOORHEES NJ
08043-4406
US

IV. Provider business mailing address

PO BOX 433
HADDONFIELD NJ
08033-0319
US

V. Phone/Fax

Practice location:
  • Phone: 609-330-9391
  • Fax:
Mailing address:
  • Phone: 609-330-9391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROBIN B. PACITTI
Title or Position: OWNER
Credential: RD
Phone: 609-330-9391