Organization
FOODSHED COOPERATIVE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MICHELLE IGOE (DIRECTOR)
(760) 297-0838
Entity
Organization
Contact information
Practice address
3340 FAIRMOUNT AVE, SAN DIEGO, CA 92105-4228
(760) 297-0838
Mailing address
3340 FAIRMOUNT AVE, SAN DIEGO, CA 92105-4228
(760) 297-0838
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
—
—
335G00000X
Medical Foods Supplier
Primary
—
—
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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