Provider Demographics
NPI:1407011323
Name:WASHWATER ASSOC.
Entity Type:Organization
Organization Name:WASHWATER ASSOC.
Other - Org Name:BENEATH IT ALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:V
Authorized Official - Last Name:SARRA
Authorized Official - Suffix:
Authorized Official - Credentials:NONE
Authorized Official - Phone:908-722-3622
Mailing Address - Street 1:72 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2216
Mailing Address - Country:US
Mailing Address - Phone:908-722-3622
Mailing Address - Fax:908-526-3957
Practice Address - Street 1:72 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2216
Practice Address - Country:US
Practice Address - Phone:908-722-3622
Practice Address - Fax:908-526-3957
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WASHWATER ASSOC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-21
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0768790001Medicare NSC