Provider Demographics
NPI:1275006736
Name:THERAFIT ENTERPRISES INC
Entity Type:Organization
Organization Name:THERAFIT ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-871-2494
Mailing Address - Street 1:511 JERMOR LN STE 102
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6152
Mailing Address - Country:US
Mailing Address - Phone:410-871-2494
Mailing Address - Fax:
Practice Address - Street 1:61 E PADONIA RD STE E
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2346
Practice Address - Country:US
Practice Address - Phone:410-415-1992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THERAFIT ENTERPRISES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD75370260Medicaid