NPI Code Details Logo

NPI 1093834020

NPI 1093834020 : PURFOODS, LLC : ANKENY, IA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1093834020
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    PURFOODS, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/29/2007
-----------------------------------------------------
    Last Update Date     |    11/19/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    3210 SE CORPORATE WOODS DR 
-----------------------------------------------------
    City                 |    ANKENY
-----------------------------------------------------
    State                |    IA
-----------------------------------------------------
    Zip                  |    50021-2502
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    515-963-0641
-----------------------------------------------------
    Fax                  |    515-266-6120
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    3210 SE CORPORATE WOODS DR 
-----------------------------------------------------
    City                 |    ANKENY
-----------------------------------------------------
    State                |    IA
-----------------------------------------------------
    Zip                  |    50021-7405
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    515-963-0641
-----------------------------------------------------
    Fax                  |    515-266-6120
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    SVP SALES & BUSINESS ENABLEMENT
-----------------------------------------------------
    Name                 |     NATHAN J JENSEN 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    515-202-6109
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    133V00000X
-----------------------------------------------------
    Taxonomy Name        |    Registered Dietitian
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    332U00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Delivered Meals
-----------------------------------------------------
    License Number       |    0196501
-----------------------------------------------------
    License Number State |    IA
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.