Provider Demographics
NPI:1174736490
Name:MEALS ON WHEELS MINISTRY, INC.
Entity type:Organization
Organization Name:MEALS ON WHEELS MINISTRY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INTERIM EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:903-593-7385
Mailing Address - Street 1:3001 ROBERTSON RD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-2507
Mailing Address - Country:US
Mailing Address - Phone:903-593-7385
Mailing Address - Fax:903-595-6350
Practice Address - Street 1:3001 ROBERTSON RD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2507
Practice Address - Country:US
Practice Address - Phone:903-593-7385
Practice Address - Fax:903-595-6350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001000891Medicaid