Provider Demographics
NPI:1871867168
Name:ATWATER INC.
Entity Type:Organization
Organization Name:ATWATER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEVIVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-733-0533
Mailing Address - Street 1:809 COURT ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-4013
Mailing Address - Country:US
Mailing Address - Phone:315-733-0533
Mailing Address - Fax:
Practice Address - Street 1:809 COURT ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4013
Practice Address - Country:US
Practice Address - Phone:315-733-0533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-04
Last Update Date:2012-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies