Provider Demographics
NPI:1245341569
Name:BIWATER SURGICAL MONITORING, LLC
Entity type:Organization
Organization Name:BIWATER SURGICAL MONITORING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RADD
Authorized Official - Middle Name:C
Authorized Official - Last Name:BERRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-947-9007
Mailing Address - Street 1:4505 WASATCH BLVD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-4709
Mailing Address - Country:US
Mailing Address - Phone:801-947-9007
Mailing Address - Fax:801-947-9994
Practice Address - Street 1:4505 WASATCH BLVD
Practice Address - Street 2:SUITE 370
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-4709
Practice Address - Country:US
Practice Address - Phone:801-947-9007
Practice Address - Fax:801-947-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies