Healthcare Provider Details

I. General information

NPI: 1457661134
Provider Name (Legal Business Name): EASYCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 12/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 E WASHINGTON ST
PRINCETON KY
42445-2250
US

IV. Provider business mailing address

108 E WASHINGTON ST
PRINCETON KY
42445-2250
US

V. Phone/Fax

Practice location:
  • Phone: 270-365-3903
  • Fax: 270-365-5543
Mailing address:
  • Phone: 800-877-0345
  • Fax: 270-365-2024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberHME00400
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberP07432
License Number StateKY

VIII. Authorized Official

Name: JAMES KNAUFF
Title or Position: CEO
Credential: C.E.O.
Phone: 270-365-3903