1407935950 NPI number — FITTING DESIGNS, INC.

Table of content: (NPI 1407935950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407935950 NPI number — FITTING DESIGNS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FITTING DESIGNS, INC.
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:
1407935950
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2645 ONEAL LN BLDG D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70816-3187
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-961-0075
Provider Business Mailing Address Fax Number:
225-273-5555

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34491A US HIGHWAY 98
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LILLIAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36549-4049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-228-6564
Provider Business Practice Location Address Fax Number:
225-273-5555
Provider Enumeration Date:
11/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SALES
Authorized Official First Name:
PHYLLIS
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
225-273-1900

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 072323 . This is a "VISTA HEALTHPLAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 215463 . This is a "HEALTHEASE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 7794177 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: B693 . This is a "WELLCARE MEDICARE HMO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: M2496 . This is a "BLUE CROSS BLUE SHIELD FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 009934592 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 025910100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: C021 . This is a "HEALTHEASE HEALTHY KIDS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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