Healthcare Provider Details

I. General information

NPI: 1366683153
Provider Name (Legal Business Name): EZ CARRIER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2009
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 HWY 75
MOUNDS OK
74047-4326
US

IV. Provider business mailing address

975 HWY 75
MOUNDS OK
74047-4326
US

V. Phone/Fax

Practice location:
  • Phone: 918-827-7876
  • Fax: 206-279-1594
Mailing address:
  • Phone: 918-827-7876
  • Fax: 206-279-1594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK GIVENS
Title or Position: PRESIDENT
Credential:
Phone: 918-827-7876