Provider Demographics
NPI:1134294960
Name:EASY LIFE MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:EASY LIFE MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MONICA
Authorized Official - Last Name:KHAMTRASHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-255-2178
Mailing Address - Street 1:1400 S DECATUR BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-8511
Mailing Address - Country:US
Mailing Address - Phone:702-255-2178
Mailing Address - Fax:702-255-2964
Practice Address - Street 1:1400 S DECATUR BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8511
Practice Address - Country:US
Practice Address - Phone:702-255-2178
Practice Address - Fax:702-255-2964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV5860040001Medicare NSC