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General NPI Number Information
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NPI Number | 1891674305
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Entity Type | Organization
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Legal Business Name | GANDOM LLC
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 1785 QUEBEC ST
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City | DENVER
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State | CO
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Zip | 80220-1900
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Country | US
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Telephone | 609-621-6788
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Fax |
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Provider Business Mailing Address
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Address Line | 4225 E MEXICO AVE APT 603
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City | DENVER
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State | CO
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Zip | 80222-4139
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Country | US
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Telephone | 609-621-6788
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KHAJA HUMAYOUN AMINI
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Credential |
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Telephone | 609-621-6788
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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 |
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License Number State |
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