MEDICARE: EZETECH CONSULTING

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1881423614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EZETECH CONSULTING

Provider Business Mailing Address
First Line	:	9108 PINEHURST DR
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-2436
Country	:	US
Telephone Number	:	920-318-9357
Fax Number	:

Provider Business Practice Location Address
First Line	:	9108 PINEHURST DR
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-2436
Country	:	US
Telephone Number	:	920-318-9357
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JORDAN KOHOUT
Credential	:
Telephone Number	:	920-318-9357

Provider Enumeration Date	:	07/30/2024
Last Update Date	:	07/30/2024

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Directions to “EZETECH CONSULTING ” Practice Location

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