Provider Demographics
NPI:1780209403
Name:NATASHA R HEWITT
Entity Type:Organization
Organization Name:NATASHA R HEWITT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:717-632-5264
Mailing Address - Street 1:250 FAME AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1587
Mailing Address - Country:US
Mailing Address - Phone:717-632-5264
Mailing Address - Fax:717-632-1165
Practice Address - Street 1:250 FAME AVE STE 220
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1587
Practice Address - Country:US
Practice Address - Phone:717-632-5264
Practice Address - Fax:717-632-1165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies