Provider Demographics
NPI:1164298576
Name:E.J.M. DURABLE ORTHOPEDICS LLC
Entity Type:Organization
Organization Name:E.J.M. DURABLE ORTHOPEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-634-0395
Mailing Address - Street 1:21350 LASSEN ST # F10
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-4254
Mailing Address - Country:US
Mailing Address - Phone:818-634-0395
Mailing Address - Fax:
Practice Address - Street 1:21350 LASSEN ST # F10
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-4254
Practice Address - Country:US
Practice Address - Phone:818-634-0395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies