Provider Demographics
NPI:1831935279
Name:MEDMEAL DIRECT, LLC
Entity type:Organization
Organization Name:MEDMEAL DIRECT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLO/CCO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGARRA
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:251-421-2667
Mailing Address - Street 1:7435 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-1103
Mailing Address - Country:US
Mailing Address - Phone:251-421-2667
Mailing Address - Fax:
Practice Address - Street 1:7435 4TH ST
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-1103
Practice Address - Country:US
Practice Address - Phone:251-421-2667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals