MemberID
VA2046
LIC
NULL
HIN
NULL
Address
919 S Church St
City
Smithfield
STATE
VA
AssignmentStatus
Tentative
Account
NULL
Client
NULL
Affiliate
Territory
NULL
Website
NULL
RegionalSponsor
NULL
XetexCode
PRVA2046
SystemID
VA2043
ParentID
VA0021
CompanyCode
Premier, Inc
ClassOfTrade
Phone
(757) 357-3291