Provider Demographics
NPI:1700196938
Name:EDEN PRAIRIE MEALS ON WHEELS
Entity Type:Organization
Organization Name:EDEN PRAIRIE MEALS ON WHEELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-221-2123
Mailing Address - Street 1:PO BOX 44334
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-1334
Mailing Address - Country:US
Mailing Address - Phone:952-221-2123
Mailing Address - Fax:952-294-4730
Practice Address - Street 1:13600 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-2251
Practice Address - Country:US
Practice Address - Phone:952-221-2123
Practice Address - Fax:952-294-4730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals