Provider Demographics
NPI:1114224672
Name:MAKE IT EASY MEDICAL DEVICES
Entity Type:Organization
Organization Name:MAKE IT EASY MEDICAL DEVICES
Other - Org Name:INTRIGUEALLIANCE
Other - Org Type:Other Name
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:AMBROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-222-1444
Mailing Address - Street 1:410 WOBURN STREET
Mailing Address - Street 2:410 WOBURN STREET
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876
Mailing Address - Country:US
Mailing Address - Phone:337-222-1097
Mailing Address - Fax:
Practice Address - Street 1:410 WOBURN STREET
Practice Address - Street 2:TEWKSBURY
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876
Practice Address - Country:US
Practice Address - Phone:337-222-1444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTRIGUE ALLIANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1110484332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment