Provider Demographics
NPI:1124194964
Name:SARATOGA ENTERPRISES INC
Entity Type:Organization
Organization Name:SARATOGA ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:LIND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:360-331-4763
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:WA
Mailing Address - Zip Code:98249-0099
Mailing Address - Country:US
Mailing Address - Phone:360-331-4763
Mailing Address - Fax:360-331-7542
Practice Address - Street 1:1609 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249
Practice Address - Country:US
Practice Address - Phone:360-331-4763
Practice Address - Fax:360-331-7542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601604070332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0210172OtherDME LABOR & INDUSTRIES
WA9063140Medicaid
WA1292060001Medicare NSC
WA9063140Medicaid