Healthcare Provider Details

I. General information

NPI: 1871427484
Provider Name (Legal Business Name): PINATA FOODS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3590 W 58TH ST
CLEVELAND OH
44102-5663
US

IV. Provider business mailing address

3590 W 58TH ST
CLEVELAND OH
44102-5663
US

V. Phone/Fax

Practice location:
  • Phone: 216-281-8811
  • Fax:
Mailing address:
  • Phone: 216-281-8811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. GRANT LORSUNG
Title or Position: CHIEF MANUFACTURING OFFICER
Credential:
Phone: 949-531-1804