Provider Demographics
NPI:1811000185
Name:REST EZ DME INC
Entity Type:Organization
Organization Name:REST EZ DME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:ESCOVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-232-3600
Mailing Address - Street 1:11886 SAN PABLO AVE
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-1752
Mailing Address - Country:US
Mailing Address - Phone:510-232-3600
Mailing Address - Fax:510-232-3111
Practice Address - Street 1:11886 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-1752
Practice Address - Country:US
Practice Address - Phone:510-232-3600
Practice Address - Fax:510-232-3111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA43185OtherHOME MEDICAL DEVICE RETAI
CA43185OtherHOME MEDICAL DEVICE RETAI