NU-ATRICS: PEDIATRIC NUTRITION & WELLNESS LLC


Address: 211 W Willow St, Fairbury, IL 61739-1172
Phone: 3098073323

NU-ATRICS: PEDIATRIC NUTRITION & WELLNESS LLC (NPI# 1033687843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033687843
Entity Type Organization
Organization Name NU-ATRICS: PEDIATRIC NUTRITION & WELLNESS LLC
Practice Address 211 W Willow St
Fairbury
IL 61739-1172
Practice Telephone 3098073323
Mailing Telephone 8154198757
Enumeration Date 2018-11-09
Last Update Date 2018-11-09
Authorized Official Name DR. ADRIAN L. BACHMAN (PRESIDENT)
Authorized Official Telephone 8154198757
Authorized Official Credential DC, MS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 332BP3500X Durable Medical Equipment & Medical Supplies
Specialization: Parenteral & Enteral Nutrition
Suppliers
Y 261QH0100X Clinic/Center
Specialization: Health Service
Ambulatory Health Care Facilities

Office Location

Street Address 211 W WILLOW ST
City FAIRBURY
State IL
Zip Code 61739-1172

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NPI Name Taxonomy Address Enumeration
1386242352 Letitride, Inc. Pharmacy 501 W Oak Street, Fairbury, IL 61739 2020-10-13
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1255748745 Brenton Waystout Nurse Practitioner 115 E Walnut St, Fairbury, IL 61739 2014-07-16
1740354117 Henry John Handler Dentist 110 N 2nd St, Fairbury, IL 61739-1116 2006-11-20
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1114313467 Champion Fitness, Inc Clinic/Center 902 E Oak St Ste 3, Fairbury, IL 61739-1301 2015-04-14
1659704740 Julie Patten Pharmacist 902 E Oak St, Fairbury, IL 61739-1390 2013-08-13
1124341250 Michelle L. Miller Specialist/Technologist 902 E Oak St, Suite 3, Fairbury, IL 61739-1390 2010-03-03
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Taxonomy Information

Taxonomy Code 261QH0100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Health Service

Taxonomy Definition

Definition to come...
Notes: [7/1/2006: modified title]

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Competitor

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City FAIRBURY
Zip Code 61739

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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