Healthcare Provider Details

I. General information

NPI: 1598682767
Provider Name (Legal Business Name): EASY AS 123 INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 PETERS CREEK RD NW
ROANOKE VA
24017-2137
US

IV. Provider business mailing address

1623 PETERS CREEK RD NW
ROANOKE VA
24017-2137
US

V. Phone/Fax

Practice location:
  • Phone: 540-815-1700
  • Fax:
Mailing address:
  • Phone: 540-815-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. MELVIN DAVIS
Title or Position: CEO
Credential:
Phone: 540-815-1700