Business Name

Business Phone

Email orders to

Website

Federal Tax ID

Type of Business Type of BusinessCafé / DeliGift StoreIndependent GroceryFlowers & GiftsConfectionsKitchen ShopNatural GroceryMeat / SeafoodEtailerFurnishings StoreDistributorFarm Store / HardwareHome & GardenGift BasketsHealthcare ServicesProduce MarketGrocery ChainWine & SpiritsFlowers & GiftsStationary Store

Buying Categories Buying CategoriesBakeryBaking IngredientsBeans, Grains & RiceBooksCanned & PickledChocolate & CandyCoffee, Tea and BeverageCondimentsCoooking IngredientsEthnic & Of-OriginFrozenGifts & SeasonalHoney & JamsHousewaresNutrition & WellnessPersonal CareSnacks

Billing Street Address

Billing City

Billing State

Billing Zip Code

Shipping Street Address

Shipping City

Shipping State

Shipping Zip Code

Contact First Name

Contact Last Name

Contact Title

Contact Email

Email Orders to

Contact Work Phone

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