Organization
EZ CARE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARTUR KRASNOPOLSKIY (OWNER)
(718) 314-3282
Entity
Organization
Contact information
Practice address
3353 SHERIDAN ST STE D, HOLLYWOOD, FL 33021-3632
(954) 981-0614
(954) 981-0663
Mailing address
3353 SHERIDAN ST STE D, HOLLYWOOD, FL 33021-3632
(954) 981-0614
(954) 981-0663
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PH24872
FL
3336C0003X
Community/Retail Pharmacy
Primary
PH24872
FL
3336L0003X
Long Term Care Pharmacy
PH25248
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003082200
—
FL
01
—
003082201
MEDICAID DME
FL
Enumeration date
09/15/2010
Last updated
07/07/2015
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