MEDICARE: EASY LIFE MEDICAL EQUIPMENT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1134294960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASY LIFE MEDICAL EQUIPMENT, INC.

Provider Business Mailing Address
First Line	:	1400 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8511
Country	:	US
Telephone Number	:	702-255-2178
Fax Number	:	702-255-2964

Provider Business Practice Location Address
First Line	:	1400 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8511
Country	:	US
Telephone Number	:	702-255-2178
Fax Number	:	702-255-2964

Authorized Official
Title or Position	:	CEO
Name	:	MARY MONICA KHAMTRASHYAN
Credential	:
Telephone Number	:	702-255-2178

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	02/18/2010

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