Provider Demographics
NPI:1952603789
Name:EASYCARE PHARMACY INC
Entity type:Organization
Organization Name:EASYCARE PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHIDOZIE
Authorized Official - Middle Name:SYLVANUS
Authorized Official - Last Name:ENWERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-381-3963
Mailing Address - Street 1:210 S KINGS AVE
Mailing Address - Street 2:UNIT L
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5705
Mailing Address - Country:US
Mailing Address - Phone:813-381-3963
Mailing Address - Fax:813-438-5911
Practice Address - Street 1:210 S KINGS AVE
Practice Address - Street 2:UNIT L
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5705
Practice Address - Country:US
Practice Address - Phone:813-381-3963
Practice Address - Fax:813-438-5911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLPH249713336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies