Provider Demographics
NPI:1144244633
Name:FITTING CONCEPTS INC
Entity Type:Organization
Organization Name:FITTING CONCEPTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LASHEA
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-841-2476
Mailing Address - Street 1:130 S INDUSTRIAL RD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-4618
Mailing Address - Country:US
Mailing Address - Phone:662-841-2476
Mailing Address - Fax:662-841-2476
Practice Address - Street 1:130 S INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-4614
Practice Address - Country:US
Practice Address - Phone:662-841-2476
Practice Address - Fax:662-841-2476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS041163411335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00040301Medicaid
MS00040301OtherPTAN 0448990001
MS0448990001Medicare ID - Type Unspecified