Provider Demographics
NPI:1083663801
Name:EZECHA ENTERPRISES, LTD
Entity Type:Organization
Organization Name:EZECHA ENTERPRISES, LTD
Other - Org Name:ABLE MEDICAL EQUIPMENT & SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:O
Authorized Official - Last Name:EZECHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-810-9140
Mailing Address - Street 1:131 PONCE DE LEON AVE NE
Mailing Address - Street 2:STE 226
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1962
Mailing Address - Country:US
Mailing Address - Phone:404-810-9140
Mailing Address - Fax:404-810-9141
Practice Address - Street 1:131 PONCE DE LEON AVE NE
Practice Address - Street 2:STE 226
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1962
Practice Address - Country:US
Practice Address - Phone:404-810-9140
Practice Address - Fax:404-810-9141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1283870001Medicare NSC