Provider Demographics
NPI:1598344277
Name:3-STEP THERAPY
Entity Type:Organization
Organization Name:3-STEP THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODIS
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:FULMORE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:954-825-3317
Mailing Address - Street 1:5100 W COPANS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-7700
Mailing Address - Country:US
Mailing Address - Phone:954-825-3317
Mailing Address - Fax:954-793-4949
Practice Address - Street 1:5100 W COPANS RD STE 300
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-7700
Practice Address - Country:US
Practice Address - Phone:954-825-3317
Practice Address - Fax:954-793-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116173500Medicaid