=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669962247
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EASY ACCESS LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2018
-----------------------------------------------------
Last Update Date | 05/18/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 152 HILLVIEW DR.
-----------------------------------------------------
City | AFTON
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 83110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-887-5496
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 602
-----------------------------------------------------
City | AFTON
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 83110-0602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-887-5496
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DEVON KUHLMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 307-887-5496
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------