Provider Demographics
NPI:1972192672
Name:WATERWAY SCIENTIFIC, LLC
Entity Type:Organization
Organization Name:WATERWAY SCIENTIFIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-593-4277
Mailing Address - Street 1:4601 N CONGRESS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3381
Mailing Address - Country:US
Mailing Address - Phone:561-593-4277
Mailing Address - Fax:
Practice Address - Street 1:4601 N CONGRESS AVE STE 102
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3381
Practice Address - Country:US
Practice Address - Phone:561-593-4277
Practice Address - Fax:561-593-4278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory