Provider Demographics
NPI:1992470249
Name:SWEET PEA NUTRITION SERVICES LLC
Entity Type:Organization
Organization Name:SWEET PEA NUTRITION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNAN
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:908-242-7759
Mailing Address - Street 1:365 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-1101
Mailing Address - Country:US
Mailing Address - Phone:908-242-7759
Mailing Address - Fax:
Practice Address - Street 1:365 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-1101
Practice Address - Country:US
Practice Address - Phone:908-242-7759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty