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General NPI Number Information
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NPI Number | 1447352695
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Entity Type | Organization
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Legal Business Name | EZ LIVING LLC
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 4031 UNIVERSITY DR SUITE 200
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City | FAIRFAX
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State | VA
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Zip | 22030-3409
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Country | US
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Telephone | 703-340-8395
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Fax | 703-879-4567
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Provider Business Mailing Address
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Address Line | 4031 UNIVERSITY DR SUITE 200
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City | FAIRFAX
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State | VA
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Zip | 22030-3409
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Country | US
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Telephone | 703-340-8395
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Fax | 703-879-4567
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Authorized Official
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Title or Position | PRESIDENT
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Name | CAROLINE GUIRGIS
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Credential |
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Telephone | 703-340-8395
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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 | 0206009298
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License Number State | VA
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