Provider Demographics
NPI:1710660014
Name:FLAVORS KITCHEN BRANDS
Entity Type:Organization
Organization Name:FLAVORS KITCHEN BRANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS-KEITH
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-743-8182
Mailing Address - Street 1:2030 WINSLOW DR APT 6
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-2233
Mailing Address - Country:US
Mailing Address - Phone:614-743-8182
Mailing Address - Fax:
Practice Address - Street 1:2030 WINSLOW DR APT 6
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-2233
Practice Address - Country:US
Practice Address - Phone:614-743-8182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals