Provider Demographics
NPI:1487028015
Name:MASTERSON'S FOOD & DRINK
Entity Type:Organization
Organization Name:MASTERSON'S FOOD & DRINK
Other - Org Name:MASTERSON'S CATERING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-636-2511
Mailing Address - Street 1:1231 LEXINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1121
Mailing Address - Country:US
Mailing Address - Phone:502-636-2511
Mailing Address - Fax:
Practice Address - Street 1:1231 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1121
Practice Address - Country:US
Practice Address - Phone:502-636-2511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals