Healthcare Provider Details

I. General information

NPI: 1366777492
Provider Name (Legal Business Name): EASY SCRIPTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5244 N SHERIDAN RD
CHICAGO IL
60640-2513
US

IV. Provider business mailing address

5244 N SHERIDAN RD
CHICAGO IL
60640-2513
US

V. Phone/Fax

Practice location:
  • Phone: 863-662-7990
  • Fax:
Mailing address:
  • Phone: 863-662-7990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number054-016725
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number054-016725
License Number StateIL

VIII. Authorized Official

Name: MR. AARON CROWLEY
Title or Position: CFO
Credential:
Phone: 863-662-7990