Provider Demographics
NPI:1972366904
Name:FOODOM INC
Entity Type:Organization
Organization Name:FOODOM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:RENETA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-391-9537
Mailing Address - Street 1:50 IRON POINT CIR STE 140
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8594
Mailing Address - Country:US
Mailing Address - Phone:408-391-9537
Mailing Address - Fax:
Practice Address - Street 1:50 IRON POINT CIR STE 140
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8594
Practice Address - Country:US
Practice Address - Phone:408-391-9537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals