Provider Demographics
NPI:1417589862
Name:BIG PICTURE NUTRITION, LLC
Entity Type:Organization
Organization Name:BIG PICTURE NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWANDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:443-477-2533
Mailing Address - Street 1:10632 LITTLE PATUXENT PKWY STE 340
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-6222
Mailing Address - Country:US
Mailing Address - Phone:443-477-2533
Mailing Address - Fax:
Practice Address - Street 1:10632 LITTLE PATUXENT PKWY STE 340
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-6222
Practice Address - Country:US
Practice Address - Phone:443-477-2533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty