Provider Demographics
NPI:1114020401
Name:G.A. FOOD SERVICES OF PINELLAS COUNTY, LLC
Entity Type:Organization
Organization Name:G.A. FOOD SERVICES OF PINELLAS COUNTY, LLC
Other - Org Name:GA FOOD SERVICES OF PINELLAS COUNTY, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER & GC
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-828-8585
Mailing Address - Street 1:12200 32ND COURT N.
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1847
Mailing Address - Country:US
Mailing Address - Phone:727-828-8585
Mailing Address - Fax:727-571-1652
Practice Address - Street 1:12200 32ND COURT N.
Practice Address - Street 2:
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-1847
Practice Address - Country:US
Practice Address - Phone:727-573-2211
Practice Address - Fax:727-572-8209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332U00000X
FLCAT62-8770332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA287428316Medicaid
TNH445136Medicaid
GA287428316BOtherSOURCE NUMBER
FL11050330Medicaid
FL382125100Medicaid