1114189206 NPI number — CAREMARK, L.L.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114189206 NPI number — CAREMARK, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAREMARK, L.L.C.
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:
Provider Other Organization Name Type Code:
6
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:
1114189206
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 840688
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75284-0688
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-225-5967
Provider Business Mailing Address Fax Number:
909-799-4364

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
125 MALLARD ST
Provider Second Line Business Practice Location Address:
STE. C
Provider Business Practice Location Address City Name:
SAINT ROSE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70087-4020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-571-3996
Provider Business Practice Location Address Fax Number:
866-540-7707
Provider Enumeration Date:
06/30/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GOLDING
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
W
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
800-225-5967

Provider Taxonomy Codes

  • Taxonomy code: 3336M0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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