Provider Demographics
NPI:1851646582
Name:A FITTING PLACE
Entity Type:Organization
Organization Name:A FITTING PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARCI
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-749-8774
Mailing Address - Street 1:209 SIBLEY ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-1226
Mailing Address - Country:US
Mailing Address - Phone:651-480-3578
Mailing Address - Fax:
Practice Address - Street 1:209 SIBLEY ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-1226
Practice Address - Country:US
Practice Address - Phone:651-480-3578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6508247332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies