Provider Demographics
NPI:1295740660
Name:EAL LEASING, INC.
Entity type:Organization
Organization Name:EAL LEASING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:LANGERVELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-988-4911
Mailing Address - Street 1:2901 AIRPORT WAY
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-1961
Mailing Address - Country:US
Mailing Address - Phone:888-988-4911
Mailing Address - Fax:
Practice Address - Street 1:2901 AIRPORT WAY
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-1961
Practice Address - Country:US
Practice Address - Phone:888-988-4911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR06013416L0300X
NV114423416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV=========OtherTAX IDENTIFICATION NUMBER
NV100509858Medicaid
NVV103513Medicare PIN