Healthcare Provider Details

I. General information

NPI: 1124194964
Provider Name (Legal Business Name): SARATOGA ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 11/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 E MAIN ST
FREELAND WA
98249
US

IV. Provider business mailing address

PO BOX 99
FREELAND WA
98249-0099
US

V. Phone/Fax

Practice location:
  • Phone: 360-331-4763
  • Fax: 360-331-7542
Mailing address:
  • Phone: 360-331-4763
  • Fax: 360-331-7542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number601604070
License Number StateWA

VIII. Authorized Official

Name: RONALD G LIND
Title or Position: PRESIDENT
Credential: RPH
Phone: 360-331-4763