Provider Demographics
NPI:1558755645
Name:PRECIOUS FOOD SERVICE, INC
Entity Type:Organization
Organization Name:PRECIOUS FOOD SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:267-850-7734
Mailing Address - Street 1:6430 N SMEDLEY ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19126-3534
Mailing Address - Country:US
Mailing Address - Phone:267-850-7734
Mailing Address - Fax:
Practice Address - Street 1:1540 E WADSWORTH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-1616
Practice Address - Country:US
Practice Address - Phone:267-850-7734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals