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General NPI Number Information
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NPI Number | 1568900348
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Entity Type | Organization
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Legal Business Name | MEDI-FIT INC
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Dates
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Enumeration Date | 02/01/2017
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 3471 E. 2153RD ROAD
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City | WEDRON
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State | IL
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Zip | 60557
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Country | US
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Telephone | 815-883-0780
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Fax |
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Provider Business Mailing Address
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Address Line | 67 HOLIDAY DR
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City | SOMONAUK
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State | IL
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Zip | 60552-9609
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Country | US
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Telephone | 815-883-0780
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID STEPHEN EMERY
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Credential |
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Telephone | 815-883-0780
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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 | 42257883
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License Number State | IL
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