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General NPI Number Information
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NPI Number | 1851615983
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Entity Type | Organization
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Legal Business Name | GRANNY,S HOME COOKED DELIVERED MEALS
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Dates
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Enumeration Date | 03/18/2010
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 1995 E. MAIN STREET
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City | LANCASTER
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State | OH
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Zip | 43130
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Country | US
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Telephone | 740-277-6445
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Fax | 740-277-6657
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Provider Business Mailing Address
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Address Line | 1995 E. MAIN STREET
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City | LANCASTER
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State | OH
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Zip | 43130
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Country | US
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Telephone | 740-277-6445
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Fax | 740-277-6657
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DAWN M. JENSEN
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Credential |
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Telephone | 740-277-6445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 132700000X
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Taxonomy Name | Dietary Manager
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License Number |
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License Number State |
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