Provider Demographics
NPI:1831433457
Name:EAT WELL GIFT BASKETS AND CONSULTING
Entity type:Organization
Organization Name:EAT WELL GIFT BASKETS AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:RODRIGUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-348-8773
Mailing Address - Street 1:4450 BLUE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-9552
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4450 BLUE RIDGE DR
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-9552
Practice Address - Country:US
Practice Address - Phone:215-348-8773
Practice Address - Fax:215-348-3557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003090133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty