Provider Demographics
NPI:1306839493
Name:CLEARWATER RESOURCES INC
Entity Type:Organization
Organization Name:CLEARWATER RESOURCES INC
Other - Org Name:ACCESS IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR CONTRACT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-873-9888
Mailing Address - Street 1:1455 BROAD STREET
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003
Mailing Address - Country:US
Mailing Address - Phone:973-873-9890
Mailing Address - Fax:973-707-1127
Practice Address - Street 1:2250 DREW STREET
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765
Practice Address - Country:US
Practice Address - Phone:727-797-0000
Practice Address - Fax:727-797-1965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC36772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE4717Medicare ID - Type Unspecified