person
Eka Maisuradze
Meals Provider in Philadelphia, Pennsylvania
NPI 1558982124

Eka Maisuradze is a Meals Provider based in Philadelphia, PA. Eka Maisuradze practices in Philadelphia, PA. The NPI Number for Eka Maisuradze is 1558982124 and holds a License No. (Pennsylvania).

The current practice location address for Eka Maisuradze is 8336 Bustleton Ave, Philadelphia, PA and can be reached out via phone at 215-742-9811. You can also correspond with Eka Maisuradze through the mailing address at 8336 BUSTLETON AVE, PHILADELPHIA, PA - 19152-1909 (mailing address contact number: 215-742-9811).

Location: 8336 Bustleton Ave, Philadelphia, PA, 19152-1909
person
Provider Profile Details
NPI Number
1558982124
Provider Name
Eka Maisuradze
Credential
Provider Entity Type
Individual
Gender
Female
Address
8336 Bustleton Ave, Philadelphia, PA, 19152-1909
Phone Number
215-742-9811
Fax Number
Provider Enumeration Date
05/05/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
8336 Bustleton Ave
City
State
Zip
19152-1909
Phone Number
215-742-9811
Fax Number
person
Provider Business Mailing Address Details
Address
8336 Bustleton Ave
City
State
Zip
19152-1909
Phone Number
215-742-9811
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Meals
Speciality
-
Taxonomy
License No.
()
Definition
A public or privately owned facility providing meals to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
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