MemberID
670408
LIC
NULL
HIN
NULL
Address
400 Broadacres Dr
Address2
Ste 4
City
Bloomfield
STATE
NJ
AssignmentStatus
NULL
Account
NULL
Client
NULL
Affiliate
Territory
NULL
Website
NULL
RegionalSponsor
NULL
XetexCode
PR670408
SystemID
605082
ParentID
605082
CompanyCode
Premier, Inc
ClassOfTrade
Phone
(201) 247-1533
Fax
(973) 377-2951