Provider Demographics
NPI:1508167008
Name:FITNESS & WELLNESS MEDICAL SUPPLY LLP
Entity Type:Organization
Organization Name:FITNESS & WELLNESS MEDICAL SUPPLY LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-889-6806
Mailing Address - Street 1:7 MAXSON AVE
Mailing Address - Street 2:
Mailing Address - City:LOCUST
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-2357
Mailing Address - Country:US
Mailing Address - Phone:732-889-6806
Mailing Address - Fax:
Practice Address - Street 1:7 MAXSON AVE
Practice Address - Street 2:
Practice Address - City:LOCUST
Practice Address - State:NJ
Practice Address - Zip Code:07760-2357
Practice Address - Country:US
Practice Address - Phone:732-889-6806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0400380493332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies