Provider Demographics
NPI:1437747151
Name:AWESOMFIT, INC
Entity Type:Organization
Organization Name:AWESOMFIT, INC
Other - Org Name:AWESOMFIT, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LARBIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-735-0148
Mailing Address - Street 1:5331 PIRRONE RD STE B
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CA
Mailing Address - Zip Code:95368-9089
Mailing Address - Country:US
Mailing Address - Phone:209-522-9911
Mailing Address - Fax:209-522-6611
Practice Address - Street 1:5331 PIRRONE RD STE B
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CA
Practice Address - Zip Code:95368-9089
Practice Address - Country:US
Practice Address - Phone:209-522-9911
Practice Address - Fax:209-522-6611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-07
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier