Healthcare Provider Details

I. General information

NPI: 1891979498
Provider Name (Legal Business Name): EAZYLIFT ALBANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 04/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 TROY SCHENECTADY RD
LATHAM NY
12110-2424
US

IV. Provider business mailing address

836 TROY SCHENECTADY RD
LATHAM NY
12110-2424
US

V. Phone/Fax

Practice location:
  • Phone: 518-393-2274
  • Fax: 888-841-5368
Mailing address:
  • Phone: 518-393-2274
  • Fax: 888-841-5368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number48-34960 0
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MS. THERESA J FARRIGAN
Title or Position: OPERATING MEMBER
Credential:
Phone: 518-393-2274