MEDICARE: EASY LIFE MEDICAL SUPPLIES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332B00000X	Durable Medical Equipment & Medical Supplies	50689	CA

General Provider Information

NPI Number	:	1225299852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASY LIFE MEDICAL SUPPLIES INC

Provider Business Mailing Address
First Line	:	2082 TAPO STREET
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063
Country	:	US
Telephone Number	:	805-526-1200
Fax Number	:	805-526-1255

Provider Business Practice Location Address
First Line	:	2082 TAPO STREET
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063
Country	:	US
Telephone Number	:	805-526-1200
Fax Number	:	805-526-1255

Authorized Official
Title or Position	:	CEO
Name	:	JOHN COLE
Credential	:
Telephone Number	:	805-526-1200

Provider Enumeration Date	:	06/17/2008
Last Update Date	:	03/27/2012

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Directions to “EASY LIFE MEDICAL SUPPLIES INC ” Practice Location

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