Provider Demographics
NPI:1649757618
Name:CITY FRESH FOODS, INC.
Entity type:Organization
Organization Name:CITY FRESH FOODS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONELL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-606-7123
Mailing Address - Street 1:77 SHIRLEY ST
Mailing Address - Street 2:
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-3035
Mailing Address - Country:US
Mailing Address - Phone:617-606-7123
Mailing Address - Fax:617-606-7126
Practice Address - Street 1:77 SHIRLEY ST
Practice Address - Street 2:
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-3035
Practice Address - Country:US
Practice Address - Phone:617-606-7123
Practice Address - Fax:617-606-7126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals