Provider Demographics
NPI:1639489230
Name:EASYCARE INC
Entity Type:Organization
Organization Name:EASYCARE INC
Other - Org Name:CORNER HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:I
Authorized Official - Last Name:KNAUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-365-3903
Mailing Address - Street 1:108 EAST WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:KY
Mailing Address - Zip Code:42445
Mailing Address - Country:US
Mailing Address - Phone:270-365-3903
Mailing Address - Fax:270-365-0835
Practice Address - Street 1:5010 BACK SQUARE DRIVE
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301
Practice Address - Country:US
Practice Address - Phone:270-686-7000
Practice Address - Fax:270-926-4448
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASYCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-15
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100157130Medicaid
KY7100157130Medicaid