| NPI | 1851808539 |
|---|---|
| Other Name | SOUTHEASTERN MILLS MIXING FACILITY & FLOUR MILL |
| Entity Type | Organization |
| Authorized Contact | MATTHEW GORMAN VP Of Corporate And Network Service 706-509-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: GA 057556) |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2022-08-08 |