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General NPI Number Information
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NPI Number | 1417608191
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Entity Type | Organization
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Legal Business Name | EVERYTABLE, PBC
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Dates
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Enumeration Date | 01/13/2022
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Last Update Date | 02/21/2022
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Provider Practice Location Address
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Address Line | 3305 E VERNON AVE
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City | VERNON
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State | CA
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Zip | 90058-1809
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Country | US
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Telephone | 213-444-5524
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 58048
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City | VERNON
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State | CA
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Zip | 90058-0048
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT,
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Name | CLARE FOX
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Credential |
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Telephone | 818-325-5872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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