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NPI Code Detail

MEDICARE: RENAISSANCE NUTRITION CENTER, INC

MEDICARE: RENAISSANCE NUTRITION CENTER, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistDN000663PA

General Provider Information

NPI Number : 1811160666
Entity Type Code : Organization
Provider Name (Legal Business Name) : RENAISSANCE NUTRITION CENTER, INC
Provider Business Mailing Address
First Line : 2500 DEKALB PIKE
Second Line : SUITE 200
City : EAST NORRITON
State : PA
Zip : 19401-2007
Country : US
Telephone Number : 610-275-3699
Fax Number : 610-275-3799
Provider Business Practice Location Address
First Line : 2500 DEKALB PIKE
Second Line : SUITE 200
City : EAST NORRITON
State : PA
Zip : 19401-2007
Country : US
Telephone Number : 610-275-3699
Fax Number : 610-275-3799
Authorized Official
Title or Position : PRESIDENT
Name : H THERESA WRIGHT
Credential : MS,RD,CDE,LDN
Telephone Number : 610-275-3699
Provider Enumeration Date : 04/11/2008
Last Update Date : 04/11/2008

Similar Medicare Providers

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Practice Location Address:
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Directions to “RENAISSANCE NUTRITION CENTER, INC ” Practice Location

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