Provider Demographics
NPI:1164025391
Name:HASTINGS NUTRITION LLC
Entity Type:Organization
Organization Name:HASTINGS NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:TZIPORA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HASTINGS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:443-983-1770
Mailing Address - Street 1:7378 PARK HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5436
Mailing Address - Country:US
Mailing Address - Phone:414-975-8672
Mailing Address - Fax:
Practice Address - Street 1:7378 PARK HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5436
Practice Address - Country:US
Practice Address - Phone:410-205-6061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty