Organization
SPRING SPA DEPOT CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARIS SILEGA (PRESIDENT)
(973) 842-6230
Entity
Organization
Contact information
Practice address
180 S ORANGE AVE APT 1405, NEWARK, NJ 07103-2766
(973) 842-6230
Mailing address
180 S ORANGE AVE APT 1405, NEWARK, NJ 07103-2766
(973) 842-6230
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
3336C0002X
Clinic Pharmacy
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
964725290
DUNS
—
Enumeration date
01/18/2015
Last updated
01/18/2015
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