Provider Demographics
NPI:1457520876
Name:NORTHWEST INDIANA MEALS ON WHEELS INC.
Entity Type:Organization
Organization Name:NORTHWEST INDIANA MEALS ON WHEELS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING AND HR MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNDI
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-756-3663
Mailing Address - Street 1:8446 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6233
Mailing Address - Country:US
Mailing Address - Phone:219-756-3663
Mailing Address - Fax:
Practice Address - Street 1:8446 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6233
Practice Address - Country:US
Practice Address - Phone:219-756-3663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100108360Medicaid