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General NPI Number Information
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NPI Number | 1962181685
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Entity Type | Organization
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Legal Business Name | MILLS VENDING LLC
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 3959 VALLEY CT UNIT E
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City | WINSTON SALEM
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State | NC
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Zip | 27106-4336
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Country | US
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Telephone | 336-813-7264
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Fax |
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Provider Business Mailing Address
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Address Line | 3959 VALLEY CT UNIT E
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City | WINSTON SALEM
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State | NC
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Zip | 27106-4336
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Country | US
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Telephone | 338-813-7264
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATER
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Name | MR. ALTON RAESHARD MILLS
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Credential |
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Telephone | 336-391-7076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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