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General NPI Number Information
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NPI Number | 1952290801
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Entity Type | Organization
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Legal Business Name | COMMUNITY SPOON HOME MEALS
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 535 HARRIS RD
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City | CHERAW
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State | SC
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Zip | 29520-4378
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Country | US
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Telephone | 803-629-7508
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Fax |
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Provider Business Mailing Address
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Address Line | 535 HARRIS RD
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City | CHERAW
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State | SC
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Zip | 29520-4378
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Country | US
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Telephone | 803-629-7508
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ISIMADORE PAULING
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Credential |
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Telephone | 803-629-7508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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