Provider Demographics
NPI:1003226275
Name:KENMORE TOWN OF TONAWANDA MEALS ON WHEELS INC
Entity Type:Organization
Organization Name:KENMORE TOWN OF TONAWANDA MEALS ON WHEELS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-874-3595
Mailing Address - Street 1:169 SHERIDAN PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-8082
Mailing Address - Country:US
Mailing Address - Phone:716-874-3595
Mailing Address - Fax:716-332-3969
Practice Address - Street 1:169 SHERIDAN PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-8082
Practice Address - Country:US
Practice Address - Phone:716-874-3595
Practice Address - Fax:716-332-3969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals