Provider Demographics
NPI:1609195361
Name:NUTRIPLEDGE, LLC
Entity Type:Organization
Organization Name:NUTRIPLEDGE, LLC
Other - Org Name:NUTRIPLEDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER,PRESIDENT AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHRADDHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUBEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RD,CD
Authorized Official - Phone:765-491-6700
Mailing Address - Street 1:3367 BOONE ST
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-1283
Mailing Address - Country:US
Mailing Address - Phone:765-491-6700
Mailing Address - Fax:
Practice Address - Street 1:3367 BOONE ST
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-1283
Practice Address - Country:US
Practice Address - Phone:765-491-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37001806A251K00000X, 251S00000X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health