Provider Demographics
NPI:1710523519
Name:MERRITT ATHLETIC CLUBS, LLC
Entity Type:Organization
Organization Name:MERRITT ATHLETIC CLUBS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WELLNESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-298-8705
Mailing Address - Street 1:2058 LORD BALTIMORE DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2501
Mailing Address - Country:US
Mailing Address - Phone:410-298-8705
Mailing Address - Fax:
Practice Address - Street 1:2058 LORD BALTIMORE DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2501
Practice Address - Country:US
Practice Address - Phone:410-298-8705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-27
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty