Provider Demographics
NPI:1679005706
Name:MEALS ON WHEELS, INC
Entity Type:Organization
Organization Name:MEALS ON WHEELS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-486-5100
Mailing Address - Street 1:1025 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-2240
Mailing Address - Country:US
Mailing Address - Phone:908-486-5100
Mailing Address - Fax:908-486-9120
Practice Address - Street 1:1025 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-2240
Practice Address - Country:US
Practice Address - Phone:908-486-5100
Practice Address - Fax:908-486-9120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ09-1069Medicaid