MEDICARE: ERGONOMICALLY CORRECT, 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	332BC3200X	Customized Equipment (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1295905834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERGONOMICALLY CORRECT, INC.

Provider Business Mailing Address
First Line	:	5737 KANAN RD
Second Line	:	#570
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-1601
Country	:	US
Telephone Number	:	818-865-9991
Fax Number	:	818-865-8808

Provider Business Practice Location Address
First Line	:	5737 KANAN RD
Second Line	:	#570
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-1601
Country	:	US
Telephone Number	:	818-865-9991
Fax Number	:	818-865-8808

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DAVID ELLIOT TIRSCH
Credential	:
Telephone Number	:	818-865-9991

Provider Enumeration Date	:	03/11/2008
Last Update Date	:	01/14/2015

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