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General NPI Number Information
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NPI Number | 1972856581
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Entity Type | Organization
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Legal Business Name | NUTRIWORLD INC.
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Dates
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Enumeration Date | 10/19/2012
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Last Update Date | 03/21/2013
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Provider Practice Location Address
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Address Line | 3453 GRAND BLVD.
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City | BROOKFIELD
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State | IL
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Zip | 60513-1207
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Country | US
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Telephone | 708-485-3422
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Fax | 708-485-3142
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Provider Business Mailing Address
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Address Line | 3453 GRAND BLVD.
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City | BROOKFIELD
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State | IL
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Zip | 60513-1207
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Country | US
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Telephone | 708-485-3422
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Fax | 708-485-3142
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. PURA ALEGRIA YARRA
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Credential | R.D.
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Telephone | 708-485-3422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number | 00009260
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 372359
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License Number State | IL
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