Individual provider · Type 1 NPI
Eka Maisuradze
Meals Provider · Philadelphia, PA
NPI number
1558982124
Active
Practice location
8336 Bustleton Ave
Philadelphia, PA 19152-1909
Other practice locations
- 8336 Bustleton Ave, Philadelphia, PA 19152-1909 · (215) 742-9811
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Meals Provider Primary | 174200000X | None listed |
Meals Provider: A public or privately owned facility providing meals to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
Other meals provider providers in Philadelphia
About NPI 1558982124
Eka Maisuradze's National Provider Identifier is 1558982124, issued on May 5, 2020. The primary taxonomy on file is Meals Provider (174200000X), and the practice location is in Philadelphia, PA. The record was last updated on May 5, 2020.