Basic Information
| Provider Information | |||||||||
| NPI: | 1891979498 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EAZYLIFT ALBANY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 836 TROY SCHENECTADY RD | ||||||||
| Address2: | |||||||||
| City: | LATHAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121102424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5183932274 | ||||||||
| FaxNumber: | 8888415368 | ||||||||
| Practice Location | |||||||||
| Address1: | 836 TROY SCHENECTADY RD | ||||||||
| Address2: | |||||||||
| City: | LATHAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121102424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5183932274 | ||||||||
| FaxNumber: | 8888415368 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2007 | ||||||||
| LastUpdateDate: | 04/22/2010 | ||||||||
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| AuthorizedOfficialLastName: | FARRIGAN | ||||||||
| AuthorizedOfficialFirstName: | THERESA | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OPERATING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 5183932274 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BN1400X | N | Suppliers | Durable Medical Equipment & Medical Supplies | Nursing Facility Supplies | 332B00000X | 48-34960 0 | NY | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332BC3200X | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment |
No ID Information.