Provider Demographics
NPI:1609147693
Name:STOMAPLEX LLC
Entity Type:Organization
Organization Name:STOMAPLEX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-560-1016
Mailing Address - Street 1:917 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3005
Mailing Address - Country:US
Mailing Address - Phone:570-560-1016
Mailing Address - Fax:
Practice Address - Street 1:917 1ST AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3005
Practice Address - Country:US
Practice Address - Phone:570-560-1016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies