Healthcare Provider Details

I. General information

NPI: 1386151561
Provider Name (Legal Business Name): EZ HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2018
Last Update Date: 01/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 LITTLE RIVER TPKE STE 325B
ANNANDALE VA
22003-2937
US

IV. Provider business mailing address

13817 GREBE ST
CLARKSBURG MD
20871-6372
US

V. Phone/Fax

Practice location:
  • Phone: 240-477-3006
  • Fax:
Mailing address:
  • Phone: 240-477-3006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: JEONGHI LEE
Title or Position: ADMINISTRATOR
Credential:
Phone: 240-477-3006