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General NPI Number Information
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NPI Number | 1043298409
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Entity Type | Organization
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Legal Business Name | WATERSTONE ACQUISITION, LLC
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 2341 W BEAVER CREEK DR
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City | POWELL
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State | TN
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Zip | 37849-4831
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Country | US
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Telephone | 800-355-7774
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Fax |
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Provider Business Mailing Address
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Address Line | 2341 W BEAVER CREEK DR
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City | POWELL
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State | TN
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Zip | 37849-4831
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Country | US
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Telephone | 800-355-7774
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JOEL EDWARD SEGAR
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Credential |
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Telephone | 423-463-9929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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