Provider Demographics
NPI:1083725600
Name:ELECTROEASE, INC
Entity Type:Organization
Organization Name:ELECTROEASE, INC
Other - Org Name:ELECTROPEDIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:KRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-845-7488
Mailing Address - Street 1:907 HOLLYWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2816
Mailing Address - Country:US
Mailing Address - Phone:818-845-7488
Mailing Address - Fax:818-953-7421
Practice Address - Street 1:907 HOLLYWOOD WAY
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2816
Practice Address - Country:US
Practice Address - Phone:818-845-7488
Practice Address - Fax:818-953-7421
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELECTROEASE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME02758FMedicaid
CA0801270001Medicare ID - Type Unspecified