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General NPI Number Information
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NPI Number | 1083764328
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Entity Type | Organization
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Legal Business Name | SARATOGA ENTERPRISES INC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 105 1ST ST
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City | LANGLEY
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State | WA
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Zip | 98260-0047
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Country | US
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Telephone | 360-221-4369
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Fax | 360-221-0828
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Provider Business Mailing Address
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Address Line | 105 1ST ST PO BOX 47
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City | LANGLEY
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State | WA
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Zip | 98260
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHRM MANG
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Name | KATHERINE STALLMAN
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Credential | RPH
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Telephone | 360-331-5270
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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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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 601604070
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License Number State | WA
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