Provider Demographics
NPI:1275330078
Name:EASE EQUIP MEDICAL SUPPLY, LLC
Entity type:Organization
Organization Name:EASE EQUIP MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:MR
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-400-3425
Mailing Address - Street 1:222 RIVER PARK NORTH DR STE A
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-7834
Mailing Address - Country:US
Mailing Address - Phone:470-400-3425
Mailing Address - Fax:
Practice Address - Street 1:222 RIVER PARK NORTH DR STE A
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-7834
Practice Address - Country:US
Practice Address - Phone:470-400-3425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies