1013014638 NPI number — CARE SERVICES, INC

Table of content: (NPI 1013014638)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013014638 NPI number — CARE SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE SERVICES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DIABETIC CARE SERVICES & PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013014638
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34099 MELINZ PKWY
Provider Second Line Business Mailing Address:
UNIT F1
Provider Business Mailing Address City Name:
EASTLAKE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44095-4041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-954-7709
Provider Business Mailing Address Fax Number:
440-954-7705

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34099 MELINZ PKWY
Provider Second Line Business Practice Location Address:
UNIT F1
Provider Business Practice Location Address City Name:
EASTLAKE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44095-4041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-954-7709
Provider Business Practice Location Address Fax Number:
440-954-7705
Provider Enumeration Date:
09/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WOLF
Authorized Official First Name:
MARC
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
C.E.O.
Authorized Official Telephone Number:
440-954-7709

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0003X , with the licence number: 020581500 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0726058 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 020581500 . This is a "OHIO ST. BD. PHARMACY" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0729180 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3650961 . This is a "NCPDP" identifier . This identifiers is of the category "OTHER".




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