Healthcare Provider Details

I. General information

NPI: 1942928841
Provider Name (Legal Business Name): SINN-FULLY DELICIOUS CATERNIG & ENT.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2022
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 WORTH ST STE C001
PHILADELPHIA PA
19124-3463
US

IV. Provider business mailing address

4939 ROYAL ST
PHILADELPHIA PA
19144-6050
US

V. Phone/Fax

Practice location:
  • Phone: 215-960-7908
  • Fax:
Mailing address:
  • Phone: 267-333-2686
  • 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 Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: MR. CRAIG J HOWARD II
Title or Position: C.E.O
Credential:
Phone: 267-333-2686