1184846669 NPI number — ALLEREADY FOODS, L.L.C.

Table of content: (NPI 1184846669)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184846669 NPI number — ALLEREADY FOODS, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLEREADY FOODS, L.L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184846669
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1622 E. LINCOLN AVE.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROYAL OAK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48067-3403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-546-3847
Provider Business Mailing Address Fax Number:
248-543-2641

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10171 COLONIAL INDUSTRIAL DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH LYON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48178-9149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-890-0177
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HALL
Authorized Official First Name:
JILL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
248-546-3847

Provider Taxonomy Codes

  • Taxonomy code: 332U00000X , with the licence number:  21619 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2463954 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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