Provider Demographics
NPI:1275308520
Name:REBUILT MEALS LLC
Entity Type:Organization
Organization Name:REBUILT MEALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-287-6655
Mailing Address - Street 1:4618 N HALE AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7056
Mailing Address - Country:US
Mailing Address - Phone:508-287-6655
Mailing Address - Fax:
Practice Address - Street 1:4618 N HALE AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7056
Practice Address - Country:US
Practice Address - Phone:508-287-6655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals