Provider Demographics
NPI:1063763068
Name:FORTIN WELDING & MFT INC
Entity type:Organization
Organization Name:FORTIN WELDING & MFT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDEND
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FORTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-291-4342
Mailing Address - Street 1:944 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2657
Mailing Address - Country:US
Mailing Address - Phone:614-291-4342
Mailing Address - Fax:614-429-6310
Practice Address - Street 1:944 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2657
Practice Address - Country:US
Practice Address - Phone:614-291-4342
Practice Address - Fax:614-429-6310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies