PURFOODS, LLC

Provider Demographics

• NPI: 1093834020
• Name: PURFOODS, LLC
• Entity type: Organization
• Organization Name: PURFOODS, LLC
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: SVP SALES & BUSINESS ENABLEMENT
• Authorized Official - First Name: NATHAN
• Authorized Official - Middle Name: J
• Authorized Official - Last Name: JENSEN
• Authorized Official - Phone: 515-202-6109
• Mailing Address - Street 1: 3210 SE CORPORATE WOODS DR
• Mailing Address - City: ANKENY
• Mailing Address - State: IA
• Mailing Address - Zip Code: 50021-7405
• Mailing Address - Country: US
• Mailing Address - Phone: 515-963-0641
• Mailing Address - Fax: 515-266-6120
• Practice Address - Street 1: 3210 SE CORPORATE WOODS DR
• Practice Address - City: ANKENY
• Practice Address - State: IA
• Practice Address - Zip Code: 50021-2502
• Practice Address - Country: US
• Practice Address - Phone: 515-963-0641
• Practice Address - Fax: 515-266-6120
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-03-29
• Last Update Date: 2025-11-19

Provider Licenses

State	License ID	Taxonomies
		133V00000X
IA	0196501	332U00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	332U00000X	Suppliers	Home Delivered Meals
No	133V00000X	Dietary & Nutritional Service Providers	Dietitian, Registered		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
UT	1093834020	Medicaid
DE	250524302	Medicaid
IL	6050138	Medicaid
TN	H445168	Medicaid
MN	086462000	Medicaid
WI	100367467	Medicaid
PA	102383905-0002	Medicaid
NC	1093834020	Medicaid
KY	7100774160	Medicaid
CO	88807550	Medicaid
FL	001653400	Medicaid
IA	019650	Medicaid
MT	1093834020	Medicaid
NM	00705268	Medicaid
ID	1093834020	Medicaid
LA	2163051	Medicaid
OH	2772316	Medicaid
OR	500842976	Medicaid
NE	99029673	Medicaid
TX	S500410290	Medicaid
HI	800401	Medicaid
SC	EX0951	Medicaid
WI	100307086	Medicaid
MA	110209233A	Medicaid
OK	200536020 A	Medicaid
IN	200925420A	Medicaid
ND	39839	Medicaid
GA	003105053A	Medicaid
WI	100292728	Medicaid
NJ	1093834020	Medicaid
MO	1093834020	Medicaid
MI	1093832040	Medicaid
NV	1093834020	Medicaid
RI	1093834020	Medicaid
SD	1093834020	Medicaid
WY	127458900	Medicaid
KS	200629550A	Medicaid
AZ	274676	Medicaid
VA	30015057200002	Medicaid
MD	6639038-00	Medicaid