Provider Demographics
NPI:1801954664
Name:ADVANCED FITNESS COMPONENTS, LLC
Entity type:Organization
Organization Name:ADVANCED FITNESS COMPONENTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BALA
Authorized Official - Middle Name:R
Authorized Official - Last Name:VATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-595-1967
Mailing Address - Street 1:1 WALL ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-3983
Mailing Address - Country:US
Mailing Address - Phone:603-595-1967
Mailing Address - Fax:603-595-7240
Practice Address - Street 1:1 WALL ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-3983
Practice Address - Country:US
Practice Address - Phone:603-595-1967
Practice Address - Fax:603-595-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment