Provider Demographics
NPI:1831832179
Name:EZED-Q LLC
Entity type:Organization
Organization Name:EZED-Q LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAZEMORE QUAYE
Authorized Official - Suffix:
Authorized Official - Credentials:DBH, CFNC, CEAP, SAP
Authorized Official - Phone:602-509-2677
Mailing Address - Street 1:5041 W NORTHERN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-1539
Mailing Address - Country:US
Mailing Address - Phone:148-063-1721
Mailing Address - Fax:
Practice Address - Street 1:5041 W NORTHERN AVE STE C
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-1539
Practice Address - Country:US
Practice Address - Phone:148-063-1721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No251K00000XAgenciesPublic Health or Welfare
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier