Provider Demographics
NPI:1629321757
Name:EZ & A, LLC
Entity Type:Organization
Organization Name:EZ & A, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-871-1144
Mailing Address - Street 1:4683 CABLE ROAD
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:SC
Mailing Address - Zip Code:29742
Mailing Address - Country:UM
Mailing Address - Phone:864-871-1144
Mailing Address - Fax:
Practice Address - Street 1:4683 CABOL RD
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:SC
Practice Address - Zip Code:29742-6785
Practice Address - Country:US
Practice Address - Phone:864-871-1144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier