Healthcare Provider Details

I. General information

NPI: 1154526499
Provider Name (Legal Business Name): DAVID AND BRENDA CATERING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3432 RHODES AVE
NEW BOSTON OH
45662-4916
US

IV. Provider business mailing address

3432 RHODES AVE
NEW BOSTON OH
45662-4916
US

V. Phone/Fax

Practice location:
  • Phone: 740-456-3663
  • Fax: 740-456-5278
Mailing address:
  • Phone: 740-456-3663
  • Fax: 740-456-5278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: DAVID G LITTERAL
Title or Position: OWNER
Credential: CEO
Phone: 740-456-3663