Provider Demographics
NPI:1023535903
Name:EMISWET E-Z LLC
Entity Type:Organization
Organization Name:EMISWET E-Z LLC
Other - Org Name:E-Z HEALTMART PHARMACY 02
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:N
Authorized Official - Last Name:ONYEKWELU
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:646-402-1848
Mailing Address - Street 1:5075 FIORELLA LN
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-5447
Mailing Address - Country:US
Mailing Address - Phone:407-915-7307
Mailing Address - Fax:407-915-7398
Practice Address - Street 1:4942 W STATE ROAD 46 STE 1014
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-9245
Practice Address - Country:US
Practice Address - Phone:407-915-7307
Practice Address - Fax:407-915-7398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28I034866003336C0003X
NYI0532953336C0004X
3336L0003X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL69-8017325664-5OtherCERTIFICATE OF REGISTRATION
FLG16000137192OtherE-Z HEALTHMART PHARMACY
FL024213700Medicaid
NJ0400464755OtherEMISWET E-Z LLC