Provider Demographics
NPI:1043285018
Name:HILL NUTRITION ASSOCIATES, INC.
Entity Type:Organization
Organization Name:HILL NUTRITION ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RD,LD/N
Authorized Official - Phone:772-220-8058
Mailing Address - Street 1:2400 SE FEDERAL HIGHWAY
Mailing Address - Street 2:SUITE #330
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-4590
Mailing Address - Country:US
Mailing Address - Phone:772-220-8058
Mailing Address - Fax:772-220-8067
Practice Address - Street 1:2400 SE FEDERAL HIGHWAY
Practice Address - Street 2:SUITE #330
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4590
Practice Address - Country:US
Practice Address - Phone:772-220-8058
Practice Address - Fax:772-220-8067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4646Medicare ID - Type Unspecified