Healthcare Provider Details

I. General information

NPI: 1538479126
Provider Name (Legal Business Name): EASYCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 07/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 ADAMS ST SUITE 24
PADUCAH KY
42001-4109
US

IV. Provider business mailing address

108 EAST WASHINGTON STREET
PRINCETON KY
42445
US

V. Phone/Fax

Practice location:
  • Phone: 270-443-3311
  • Fax: 270-442-7710
Mailing address:
  • Phone: 270-365-3903
  • Fax: 270-365-0835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES I KNAUFF
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 270-365-3903