1225352214 NPI number — FOODS FOR ALL REASONS, INC

Table of content: MIRANDA JEANETTE ADAMS MS (NPI 1124023924)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225352214 NPI number — FOODS FOR ALL REASONS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOODS FOR ALL REASONS, INC
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:
6
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:
1225352214
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
123 SKYLINE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RINGWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07456-2013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-962-6355
Provider Business Mailing Address Fax Number:
973-962-9333

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
123 SKYLINE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RINGWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07456-2013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-962-6355
Provider Business Practice Location Address Fax Number:
973-962-9333
Provider Enumeration Date:
03/18/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GAROFANO
Authorized Official First Name:
DONA
Authorized Official Middle Name:
Authorized Official Title or Position:
NATUROPATH
Authorized Official Telephone Number:
973-962-6355

Provider Taxonomy Codes

  • Taxonomy code: 332900000X , with the licence number:  0100151778 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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