Basic Information
| Provider Information | |||||||||
| NPI: | 1457004145 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | EASYSCRIPTS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9250 W FLAGLER ST STE 600 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331743460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054488100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4943 SHERIDAN ST | ||||||||
| Address2: | |||||||||
| City: | HOLLYWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330212829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548901441 | ||||||||
| FaxNumber: | 8448231714 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2022 | ||||||||
| LastUpdateDate: | 02/02/2022 | ||||||||
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| AuthorizedOfficialLastName: | GERSTENKORN | ||||||||
| AuthorizedOfficialFirstName: | KRISTI | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | PHARMACY DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7864956409 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | EASYSCRIPTS LLC | ||||||||
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| AuthorizedOfficialCredential: | PHARMD | ||||||||
| NPICertificationDate: | 02/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0003X | Y | Suppliers | Pharmacy | Community/Retail Pharmacy |
No ID Information.