Provider Demographics
NPI:1124377205
Name:THE FITTER'S CORNER, LLC
Entity Type:Organization
Organization Name:THE FITTER'S CORNER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:MCQUEEN
Authorized Official - Suffix:
Authorized Official - Credentials:CMF
Authorized Official - Phone:609-675-1288
Mailing Address - Street 1:615 EAST MOSS MILL ROAD, STORE A-5
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08205
Mailing Address - Country:US
Mailing Address - Phone:856-825-3853
Mailing Address - Fax:
Practice Address - Street 1:615 EAST MOSS MILL ROAD, STORE A-5
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08205
Practice Address - Country:US
Practice Address - Phone:856-825-3853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies