Provider Demographics
NPI:1447560024
Name:EASYCARE INC
Entity Type:Organization
Organization Name:EASYCARE INC
Other - Org Name:PHARMACY CORNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KNAUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-365-3903
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:KY
Mailing Address - Zip Code:42445-0607
Mailing Address - Country:US
Mailing Address - Phone:270-365-3903
Mailing Address - Fax:270-365-2024
Practice Address - Street 1:700 CASSIDY AVE
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:KY
Practice Address - Zip Code:42411-9207
Practice Address - Country:US
Practice Address - Phone:270-545-3413
Practice Address - Fax:270-365-2024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-15
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
KYP074303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2129507OtherPK