Provider Demographics
NPI:1902386931
Name:EASY FLO N GO LLC
Entity Type:Organization
Organization Name:EASY FLO N GO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOPYEE
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-403-4800
Mailing Address - Street 1:14468 FAUCET LN
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46040-9495
Mailing Address - Country:US
Mailing Address - Phone:317-403-4800
Mailing Address - Fax:
Practice Address - Street 1:14468 FAUCET LN
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46040-9495
Practice Address - Country:US
Practice Address - Phone:317-403-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health