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General NPI Number Information
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NPI Number | 1881141307
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Entity Type | Organization
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Legal Business Name | MILK AND HONEY FARM LLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 2442 BROOKFIELD DR.
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City | GROVER
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State | NC
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Zip | 28073
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Country | US
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Telephone | 704-482-6785
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Fax | 704-482-8021
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Provider Business Mailing Address
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Address Line | PO BOX 473
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City | SHELBY
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State | NC
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Zip | 28151
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Country | US
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Telephone | 704-297-5023
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Fax | 704-482-8021
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. LATARSHA R. GULLATTE
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Credential |
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Telephone | 704-297-5023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | 7935972
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License Number State | NC
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