Provider Demographics
NPI:1649937236
Name:TANGELO - INTEND, INC.
Entity type:Organization
Organization Name:TANGELO - INTEND, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:NATHAN
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-671-2995
Mailing Address - Street 1:550 W MERRILL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-1443
Mailing Address - Country:US
Mailing Address - Phone:503-936-1400
Mailing Address - Fax:
Practice Address - Street 1:550 W MERRILL ST STE 100
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-1443
Practice Address - Country:US
Practice Address - Phone:503-936-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335G00000XSuppliersMedical Foods Supplier
No332U00000XSuppliersHome Delivered Meals