Healthcare Provider Details
I. General information
NPI: 1659443224
Provider Name (Legal Business Name): SARATOGA ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
105 1ST ST
LANGLEY WA
98260
US
IV. Provider business mailing address
PO BOX 99
FREELAND WA
98249-0099
US
V. Phone/Fax
- Phone: 360-331-4763
- Fax: 360-331-7542
- Phone: 360-331-4763
- Fax: 360-331-7542
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | WA |
VIII. Authorized Official
Name:
RON
C
LIND
Title or Position: PRESIDENT
Credential: RPH
Phone: 360-331-4763