Provider Demographics
NPI:1093072118
Name:RUTH MALDONADO
Entity Type:Organization
Organization Name:RUTH MALDONADO
Other - Org Name:EZ MOBILITY DURABLE MEDICAL EQUIPMENT & SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-352-9200
Mailing Address - Street 1:10220 HOLE AVE.
Mailing Address - Street 2:SUITE 6
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3438
Mailing Address - Country:US
Mailing Address - Phone:951-352-9200
Mailing Address - Fax:951-352-9210
Practice Address - Street 1:10220 HOLE AVE.
Practice Address - Street 2:SUITE 6
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3438
Practice Address - Country:US
Practice Address - Phone:951-352-9200
Practice Address - Fax:951-352-9210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier