Provider Demographics
NPI:1346870730
Name:EZ HEALTH AND HOSPICE CARE LLC.
Entity Type:Organization
Organization Name:EZ HEALTH AND HOSPICE CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADIMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CUTHBERT
Authorized Official - Middle Name:I
Authorized Official - Last Name:MAYERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:617-433-2993
Mailing Address - Street 1:58 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-2760
Mailing Address - Country:US
Mailing Address - Phone:617-872-5192
Mailing Address - Fax:508-857-2354
Practice Address - Street 1:58 DIVISION ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2760
Practice Address - Country:US
Practice Address - Phone:617-872-5192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110094684AMedicaid