Provider Demographics
NPI:1023363983
Name:MAGIC KITCHEN, INC.
Entity Type:Organization
Organization Name:MAGIC KITCHEN, INC.
Other - Org Name:MAGICKITCHEN.COM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-492-3220
Mailing Address - Street 1:11310 W 80TH ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-3307
Mailing Address - Country:US
Mailing Address - Phone:816-492-3220
Mailing Address - Fax:816-492-3221
Practice Address - Street 1:11310 W 80TH ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-3307
Practice Address - Country:US
Practice Address - Phone:816-492-3220
Practice Address - Fax:816-492-3221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals