Provider Demographics
NPI:1588264337
Name:APPLE RED NUTRITION SERVICES
Entity type:Organization
Organization Name:APPLE RED NUTRITION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AFUA-BEMA
Authorized Official - Middle Name:ISOKEN
Authorized Official - Last Name:KHUMALO
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:909-528-9828
Mailing Address - Street 1:10881 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2226
Mailing Address - Country:US
Mailing Address - Phone:909-528-9828
Mailing Address - Fax:
Practice Address - Street 1:341 W 2ND ST STE 3
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1804
Practice Address - Country:US
Practice Address - Phone:909-513-5351
Practice Address - Fax:909-635-6132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-30
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty