Provider Demographics
NPI:1508173188
Name:SAW CORP
Entity Type:Organization
Organization Name:SAW CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHON
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:406-471-9268
Mailing Address - Street 1:701 SMELTER AVE NE
Mailing Address - Street 2:DR. WEAVER
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1940
Mailing Address - Country:US
Mailing Address - Phone:406-761-3461
Mailing Address - Fax:
Practice Address - Street 1:701 SMELTER AVE NE
Practice Address - Street 2:DR. WEAVER
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-1940
Practice Address - Country:US
Practice Address - Phone:406-761-3461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT779152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty