Provider Demographics
NPI:1871932350
Name:THERAFIT ENTERPRISES, INC.
Entity type:Organization
Organization Name:THERAFIT ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-871-2494
Mailing Address - Street 1:511 JERMOR LN STE 102
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6152
Mailing Address - Country:US
Mailing Address - Phone:410-871-2494
Mailing Address - Fax:410-861-5303
Practice Address - Street 1:511 JERMOR LN STE 102
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-871-2494
Practice Address - Fax:410-861-5303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD254914000Medicaid