Healthcare Provider Details

I. General information

NPI: 1326379520
Provider Name (Legal Business Name): EASY SCRIPTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2307 S MOUNT PROSPECT RD
DES PLAINES IL
60018-1811
US

IV. Provider business mailing address

2307 S MOUNT PROSPECT RD
DES PLAINES IL
60018-1811
US

V. Phone/Fax

Practice location:
  • Phone: 847-849-6634
  • Fax:
Mailing address:
  • Phone: 847-849-6634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number054.016789
License Number StateIL

VIII. Authorized Official

Name: SHAWN E TAVARES
Title or Position: DIRECTOR/PHARMACIST
Credential: RPH
Phone: 808-873-6424