Healthcare Provider Details

I. General information

NPI: 1982740502
Provider Name (Legal Business Name): EANAS AND LYLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 W 9TH AVE
SPOKANE WA
99204-3025
US

IV. Provider business mailing address

1005 W 9TH AVE
SPOKANE WA
99204-3025
US

V. Phone/Fax

Practice location:
  • Phone: 509-462-9006
  • Fax: 509-838-7438
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code332100000X
TaxonomyDepartment of Veterans Affairs (VA) Pharmacy
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberFL00058242
License Number StateWA

VIII. Authorized Official

Name: W EVANS
Title or Position: PRESIDENT OWNER
Credential:
Phone: 509-838-3145