=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932925419
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEALS 4 MOM FOUNDATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2024
-----------------------------------------------------
Last Update Date | 11/29/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 RIGHTERS FERRY RD PH 604
-----------------------------------------------------
City | BALA CYNWYD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19004-1345
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-883-6325
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 45 E CITY AVE UNIT 309
-----------------------------------------------------
City | BALA CYNWYD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19004-2421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-883-6325
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | WAKEETA ROWE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 215-240-2402
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174200000X
-----------------------------------------------------
Taxonomy Name | Meals Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332U00000X
-----------------------------------------------------
Taxonomy Name | Home Delivered Meals
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------