1518197813 NPI number — A BETTER FIT

Table of content: (NPI 1518197813)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518197813 NPI number — A BETTER FIT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A BETTER FIT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518197813
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
175 BELMONT DR
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
DOTHAN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36305-6506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-673-3481
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
175 BELMONT DR
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
DOTHAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36305-6506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-673-3481
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/21/2009

Additional Information

Authorized Official

Authorized Official Last Name:
GAY
Authorized Official First Name:
RHONDA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER/CEO
Authorized Official Telephone Number:
334-673-3481

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 51066859 . This is a "BLUE ADVANTAGE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 51066859 . This is a "BLUE CROSS BLUE SHIELD OF ALABAMA" identifier . This identifiers is of the category "OTHER".




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