Provider Demographics
NPI:1861488397
Name:EASYPHARMACY INC.
Entity type:Organization
Organization Name:EASYPHARMACY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARVATRAO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:908-722-7002
Mailing Address - Street 1:931 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:MANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08835-2007
Mailing Address - Country:US
Mailing Address - Phone:908-722-7002
Mailing Address - Fax:908-722-7262
Practice Address - Street 1:931 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:MANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08835-2007
Practice Address - Country:US
Practice Address - Phone:908-722-7002
Practice Address - Fax:908-722-7262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS615100333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8906700Medicaid
NJ8906718Medicaid
NJ4614950001Medicare NSC