Provider Demographics
NPI:1043987829
Name:TRINITY RENAL FOOD SERVICES
Entity Type:Organization
Organization Name:TRINITY RENAL FOOD SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-472-0989
Mailing Address - Street 1:301 SPRING GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:NJ
Mailing Address - Zip Code:08095
Mailing Address - Country:US
Mailing Address - Phone:856-472-0989
Mailing Address - Fax:
Practice Address - Street 1:301 SPRING GARDEN RD
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2516
Practice Address - Country:US
Practice Address - Phone:856-472-0989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals