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General NPI Number Information
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NPI Number | 1508167008
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Entity Type | Organization
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Legal Business Name | FITNESS & WELLNESS MEDICAL SUPPLY LLP
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Dates
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Enumeration Date | 11/15/2010
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Last Update Date | 12/14/2010
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Provider Practice Location Address
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Address Line | 7 MAXSON AVE
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City | LOCUST
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State | NJ
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Zip | 07760-2357
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Country | US
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Telephone | 732-889-6806
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Fax |
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Provider Business Mailing Address
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Address Line | 7 MAXSON AVE
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City | LOCUST
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State | NJ
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Zip | 07760-2357
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Country | US
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Telephone | 732-889-6806
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED PARTNER
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Name | MR. JOHN R MURRAY
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Credential |
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Telephone | 732-889-6806
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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 | 0400380493
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License Number State | NJ
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