Provider Demographics
NPI:1588989545
Name:DERRINGER FOOD SERVICES, INC.
Entity type:Organization
Organization Name:DERRINGER FOOD SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MAYBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-272-3480
Mailing Address - Street 1:5530 FAIR LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-3402
Mailing Address - Country:US
Mailing Address - Phone:513-272-3480
Mailing Address - Fax:513-272-2075
Practice Address - Street 1:5530 FAIR LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-3402
Practice Address - Country:US
Practice Address - Phone:513-272-3480
Practice Address - Fax:513-272-2075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals