Provider Demographics
NPI:1568900348
Name:MEDI-FIT INC
Entity Type:Organization
Organization Name:MEDI-FIT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:EMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-883-0780
Mailing Address - Street 1:67 HOLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:SOMONAUK
Mailing Address - State:IL
Mailing Address - Zip Code:60552-9609
Mailing Address - Country:US
Mailing Address - Phone:815-883-0780
Mailing Address - Fax:
Practice Address - Street 1:3471 E. 2153RD ROAD
Practice Address - Street 2:
Practice Address - City:WEDRON
Practice Address - State:IL
Practice Address - Zip Code:60557
Practice Address - Country:US
Practice Address - Phone:815-883-0780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL42257883332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies