Provider Demographics
NPI:1578649687
Name:KALISTHENICS, LLC
Entity type:Organization
Organization Name:KALISTHENICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVAZIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-350-1770
Mailing Address - Street 1:1000 FLORAL VALE BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5570
Mailing Address - Country:US
Mailing Address - Phone:215-622-7207
Mailing Address - Fax:267-548-3066
Practice Address - Street 1:1926 E CEDAR ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-8009
Practice Address - Country:US
Practice Address - Phone:800-840-9041
Practice Address - Fax:267-548-3066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73272332B00000X
CTCSW.0002789332B00000X
LADME.000237332B00000X
NC02151332B00000X
IN69001172A332B00000X
KS16-44473332B00000X
KYHME000764332B00000X
OHHMEL.11616332B00000X
SC15061332B00000X
PA6000008483332B00000X
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1313843OtherHOME MEDICAL EQUIPMENT PROVIDER
FL1313843OtherHOME MEDICAL EQUIPMENT PROVIDER