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General NPI Number Information
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NPI Number | 1235452517
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Entity Type | Organization
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Legal Business Name | TINA'S MEALS LLC
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 1032 JACKSON ST
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City | CINCINNATI
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State | OH
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Zip | 45215-1645
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Country | US
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Telephone | 513-227-4221
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Fax |
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Provider Business Mailing Address
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Address Line | 1032 JACKSON ST
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City | CINCINNATI
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State | OH
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Zip | 45215-1645
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Country | US
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Telephone | 513-227-4221
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. LEVAR DANTE KHALFANI
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Credential |
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Telephone | 513-497-7580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number | 200934500526
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License Number State | OH
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