Provider Demographics
NPI:1396373346
Name:FUEL THE FIRE
Entity Type:Organization
Organization Name:FUEL THE FIRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANON
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:SAFI
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:484-553-7294
Mailing Address - Street 1:1521 LEHIGH PKWY N
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-2912
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4060 BROADWAY
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5255
Practice Address - Country:US
Practice Address - Phone:484-553-7294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-27
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty