Provider Demographics
NPI:1750685392
Name:LASTING LIFESTYLES, LLC
Entity Type:Organization
Organization Name:LASTING LIFESTYLES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-635-9900
Mailing Address - Street 1:250 PINE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9353
Mailing Address - Country:US
Mailing Address - Phone:412-635-9900
Mailing Address - Fax:412-635-9901
Practice Address - Street 1:250 PINE CREEK RD
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9353
Practice Address - Country:US
Practice Address - Phone:412-635-9900
Practice Address - Fax:412-635-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies