Rustic Canteen, LLC

Primary specialty

Home Delivered MealsTaxonomy code 332U00000X

Legal business name

RUSTIC CANTEEN, LLC

Practice address

6465 W Colfax Ave
Lakewood, CO 80214-1801

Phone

(949) 463-0603

NPI assigned

Sep 7, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marco Ramirez

Title

Owner

Phone

(949) 463-0603

Specialties & licenses 1

Addresses

Other names 1

• FTC Kitchen Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1629803697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PASADA VALIENTE",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926881983",
            "telephone_number": "949-463-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 W COLFAX AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802141801",
            "telephone_number": "949-463-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSTIC CANTEEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-07",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "RAMIREZ",
        "authorized_official_first_name": "MARCO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-463-0603"
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FTC Kitchen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Russell, RBT
• Faith Anastasia Russell, DPT
• Judith Kay Russell, GNP
• Kylie Amber Russo, OTR
• Jared Rust
• Betty A Rutledge, LPN
• Daisy M Ruvalcaba, RBT
• Michael I. Ruxin, M.D.
• RW Universal Enterprise PLLC
• Ryan Kramer MD PC

• Home Delivered Meals in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Home Delivered Meals in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.