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General NPI Number Information
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NPI Number | 1427884568
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Entity Type | Organization
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Legal Business Name | SEED2SOURCE CORPORATION
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 1600 N ORANGE AVE STE 3
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City | ORLANDO
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State | FL
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Zip | 32804-6417
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Country | US
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Telephone | 386-451-7031
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Fax |
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Provider Business Mailing Address
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Address Line | 1703 N INDIAN RIVER RD
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32169-2140
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Country | US
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Telephone | 386-451-7031
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Fax |
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Authorized Official
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Title or Position | OWNER/COO
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Name | MR. ADAM DANIEL WRIGHT
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Credential |
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Telephone | 386-451-7031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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