=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073661518
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ENJOY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1900 N COMMERCIAL ST
-----------------------------------------------------
City | HARRISONVILLE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64701-1253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-590-9662
-----------------------------------------------------
Fax | 816-884-3338
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23901 E 267TH ST
-----------------------------------------------------
City | HARRISONVILLE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64701-3266
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-590-9662
-----------------------------------------------------
Fax | 816-884-3338
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. DEBI A DEGRAEVE
-----------------------------------------------------
Credential | CPED
-----------------------------------------------------
Telephone | 816-590-9662
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------