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General NPI Number Information
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NPI Number | 1245341569
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Entity Type | Organization
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Legal Business Name | BIWATER SURGICAL MONITORING, LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/17/2010
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Provider Practice Location Address
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Address Line | 4505 WASATCH BLVD SUITE 370
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City | SALT LAKE CITY
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State | UT
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Zip | 84124-4709
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Country | US
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Telephone | 801-947-9007
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Fax | 801-947-9994
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Provider Business Mailing Address
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Address Line | 4505 WASATCH BLVD SUITE 370
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City | SALT LAKE CITY
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State | UT
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Zip | 84124-4709
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Country | US
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Telephone | 801-947-9007
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Fax | 801-947-9994
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. RADD C BERRETT
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Credential |
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Telephone | 801-947-9007
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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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