Provider Demographics
NPI:1427884568
Name:SEED2SOURCE CORPORATION
Entity type:Organization
Organization Name:SEED2SOURCE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COO
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-451-7031
Mailing Address - Street 1:1703 N INDIAN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32169-2140
Mailing Address - Country:US
Mailing Address - Phone:386-451-7031
Mailing Address - Fax:
Practice Address - Street 1:1600 N ORANGE AVE STE 3
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-6417
Practice Address - Country:US
Practice Address - Phone:386-451-7031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals