Provider Demographics
NPI:1598935843
Name:MEALS ON WHEELS OF TAMPA, INC.
Entity Type:Organization
Organization Name:MEALS ON WHEELS OF TAMPA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-238-8410
Mailing Address - Street 1:550 W HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1302
Mailing Address - Country:US
Mailing Address - Phone:813-238-8410
Mailing Address - Fax:813-239-2901
Practice Address - Street 1:550 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1302
Practice Address - Country:US
Practice Address - Phone:813-238-8410
Practice Address - Fax:813-239-2901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174200000X
FLCAT3911807332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
No174200000XOther Service ProvidersMeals
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6863515 00Medicaid
FL686351500Medicaid