MEDICARE: THE CULINARY CONCIERGE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174200000X	Meals Provider
2	332U00000X	Home Delivered Meals

General Provider Information

NPI Number	:	1427927425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CULINARY CONCIERGE LLC

Provider Business Mailing Address
First Line	:	2471 S 10TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-3248
Country	:	US
Telephone Number	:	414-788-2530
Fax Number	:

Provider Business Practice Location Address
First Line	:	2471 S 10TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-3248
Country	:	US
Telephone Number	:	414-788-2530
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHETEAKA NOBLIN
Credential	:
Telephone Number	:	414-788-2530

Provider Enumeration Date	:	10/30/2025
Last Update Date	:	10/30/2025

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