Provider Demographics
NPI:1811189905
Name:EZ-MEDICAL SUPPLIES & SERVICES INC.
Entity Type:Organization
Organization Name:EZ-MEDICAL SUPPLIES & SERVICES INC.
Other - Org Name:EZ-MEDICAL SUPPLIES & SERVICES INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MONDAY
Authorized Official - Middle Name:NNA
Authorized Official - Last Name:EZEBUNWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-248-1401
Mailing Address - Street 1:1724 DALLAS DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-1402
Mailing Address - Country:US
Mailing Address - Phone:225-248-1401
Mailing Address - Fax:225-248-1404
Practice Address - Street 1:1724 DALLAS DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-1402
Practice Address - Country:US
Practice Address - Phone:224-248-1401
Practice Address - Fax:225-248-1404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies