Healthcare Provider Details

I. General information

NPI: 1245836576
Provider Name (Legal Business Name): RED CATERING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2020
Last Update Date: 12/10/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 TOWNSEND BLVD
JACKSONVILLE FL
32277-3709
US

IV. Provider business mailing address

3550 CAROLINE VALE BLVD
JACKSONVILLE FL
32277-9313
US

V. Phone/Fax

Practice location:
  • Phone: 904-442-3732
  • Fax:
Mailing address:
  • Phone: 904-442-3732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: REINA VALDES
Title or Position: OWNER
Credential:
Phone: 786-291-7394