Provider Demographics
NPI:1912588989
Name:CMCC FITNESS LLC
Entity Type:Organization
Organization Name:CMCC FITNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TERRITORY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:LORENZI
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:724-689-9010
Mailing Address - Street 1:150 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEW STANTON
Mailing Address - State:PA
Mailing Address - Zip Code:15672-9795
Mailing Address - Country:US
Mailing Address - Phone:412-930-4393
Mailing Address - Fax:
Practice Address - Street 1:150 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:NEW STANTON
Practice Address - State:PA
Practice Address - Zip Code:15672-9795
Practice Address - Country:US
Practice Address - Phone:412-930-4393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CMCC FITNESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care