Healthcare Provider Details

I. General information

NPI: 1538967674
Provider Name (Legal Business Name): MERCATO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W B ST FL 4
SAN DIEGO CA
92101-3537
US

IV. Provider business mailing address

550 W B ST FL 4
SAN DIEGO CA
92101-3537
US

V. Phone/Fax

Practice location:
  • Phone: 347-831-7015
  • Fax:
Mailing address:
  • Phone: 347-831-7015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT BRANNIGAN
Title or Position: CEO
Credential:
Phone: 347-831-7015