Provider Demographics
NPI:1518150630
Name:WE FIT SHOP INCORPORATED
Entity Type:Organization
Organization Name:WE FIT SHOP INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-484-1022
Mailing Address - Street 1:1416 REISTERSTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3830
Mailing Address - Country:US
Mailing Address - Phone:410-484-1022
Mailing Address - Fax:410-484-9274
Practice Address - Street 1:1416 REISTERSTOWN ROAD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-3830
Practice Address - Country:US
Practice Address - Phone:410-484-1022
Practice Address - Fax:410-484-9274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0306430001Medicare NSC