Provider Demographics
NPI:1942520739
Name:EZ SUPPLY
Entity Type:Organization
Organization Name:EZ SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CINTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOTKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-721-5302
Mailing Address - Street 1:2013 20TH LN
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3566
Mailing Address - Country:US
Mailing Address - Phone:561-721-5302
Mailing Address - Fax:866-699-5954
Practice Address - Street 1:809 WEST CENTRAL BLVD
Practice Address - Street 2:
Practice Address - City:CAPE CANEVARAL
Practice Address - State:FL
Practice Address - Zip Code:32920
Practice Address - Country:US
Practice Address - Phone:561-721-5302
Practice Address - Fax:186-632-2732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies