=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972306769
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EVEREASE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2025
-----------------------------------------------------
Last Update Date | 03/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20175 BLACK HORSE SQ
-----------------------------------------------------
City | ASHBURN
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20147-3326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-573-2190
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20175 BLACK HORSE SQ
-----------------------------------------------------
City | ASHBURN
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20147-3326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-573-2190
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BILLING MANAGER
-----------------------------------------------------
Name | MR. CHRIS HARRIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 571-573-2190
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------