Provider Demographics
NPI:1417608191
Name:EVERYTABLE, PBC
Entity Type:Organization
Organization Name:EVERYTABLE, PBC
Other - Org Name:EVERYTABLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT,
Authorized Official - Prefix:
Authorized Official - First Name:CLARE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-325-5872
Mailing Address - Street 1:PO BOX 58048
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CA
Mailing Address - Zip Code:90058-0048
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3305 E VERNON AVE
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CA
Practice Address - Zip Code:90058-1809
Practice Address - Country:US
Practice Address - Phone:213-444-5524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332U00000XSuppliersHome Delivered MealsGroup - Single Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Single Specialty