Provider Demographics
NPI:1821457920
Name:SRW INTERNATIONAL, LLC
Entity Type:Organization
Organization Name:SRW INTERNATIONAL, LLC
Other - Org Name:CORE DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:STASTNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-253-2489
Mailing Address - Street 1:1299 S OCEAN BLVD
Mailing Address - Street 2:F3
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-7749
Mailing Address - Country:US
Mailing Address - Phone:443-253-2489
Mailing Address - Fax:
Practice Address - Street 1:1299 S OCEAN BLVD
Practice Address - Street 2:F3
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-7749
Practice Address - Country:US
Practice Address - Phone:443-253-2489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment