| NPI | 1952250920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CARODINE Owner 901-791-5624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174200000X Meals |
| Additional Taxonomies | 335G00000X Medical Foods Supplier |
| Enumeration Date | 2026-01-23 |
| Last Update Date | 2026-01-23 |