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General NPI Number Information
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NPI Number | 1245319755
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Entity Type | Organization
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Legal Business Name | E Z HEALTH MEDICAL SUPPLY, INC
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 4350 W THUNDERBIRD RD
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City | GLENDALE
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State | AZ
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Zip | 85306-5027
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Country | US
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Telephone | 602-298-1247
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Fax | 602-298-1248
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Provider Business Mailing Address
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Address Line | 4350 W THUNDERBIRD RD
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City | GLENDALE
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State | AZ
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Zip | 85306-5027
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Country | US
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Telephone | 602-298-1247
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Fax | 602-298-1248
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Authorized Official
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Title or Position | PRESIDENT
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Name | GABRIEL KHACHAKYAN
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Credential |
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Telephone | 602-298-1247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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