=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023803541
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRESSHPREP LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/14/2025
-----------------------------------------------------
Last Update Date | 04/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1757 URBANA RD
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44112-1412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-925-2424
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1757 URBANA RD
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44112-1412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-925-2424
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DAWAWN WHITNER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 216-925-2424
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174200000X
-----------------------------------------------------
Taxonomy Name | Meals Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------