Provider Demographics
NPI:1497272868
Name:ENSURA HEALTH LLC
Entity Type:Organization
Organization Name:ENSURA HEALTH LLC
Other - Org Name:CUSTOM FIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DONAHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-910-6373
Mailing Address - Street 1:4616 25TH AVE NE # 293
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4183
Mailing Address - Country:US
Mailing Address - Phone:800-503-1769
Mailing Address - Fax:509-320-4502
Practice Address - Street 1:1601 N DIVISION ST STE G
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2427
Practice Address - Country:US
Practice Address - Phone:800-503-1769
Practice Address - Fax:509-320-4502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-27
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment