Provider Demographics
NPI:1760001853
Name:MONROE COUNTY MEALS ON WHEELS, INC.
Entity Type:Organization
Organization Name:MONROE COUNTY MEALS ON WHEELS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:FARERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-424-8794
Mailing Address - Street 1:901 POLK VALLEY RD STE 104
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-9559
Mailing Address - Country:US
Mailing Address - Phone:570-424-8794
Mailing Address - Fax:570-227-1340
Practice Address - Street 1:901 POLK VALLEY RD STE 104
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-9559
Practice Address - Country:US
Practice Address - Phone:570-424-8794
Practice Address - Fax:570-227-1340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017305300002Medicaid