Basic Information
Provider Information
NPI: 1104435742
EntityType: 2
ReplacementNPI:  
OrganizationName: EASYSCRIPTS LLC
LastName:  
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Mailing Information
Address1: 9250 W FLAGLER STREET, STE 600
Address2:  
City: MIAMI
State: FL
PostalCode: 331743460
CountryCode: US
TelephoneNumber: 3054488100
FaxNumber:  
Practice Location
Address1: 2601 S MILITARY TRL STE 1
Address2:  
City: WEST PALM BEACH
State: FL
PostalCode: 334157509
CountryCode: US
TelephoneNumber: 5618355002
FaxNumber: 8448231712
Other Information
ProviderEnumerationDate: 07/29/2020
LastUpdateDate: 07/07/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GERSTENKORN
AuthorizedOfficialFirstName: KRISTI
AuthorizedOfficialMiddleName: MARIE
AuthorizedOfficialTitleorPosition: PHARMACY DIRECTOR
AuthorizedOfficialTelephone: 7864956409
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: PHARMD
NPICertificationDate: 07/07/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
3336C0003X  Y SuppliersPharmacyCommunity/Retail Pharmacy

ID Information
IDTypeStateIssuerDescription
PH3282201FLFLORIDA BOARD OF PHARMACYOTHER


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