1134100134 NPI number — CAREMARK, L.L.C.

Table of content: (NPI 1134100134)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134100134 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:
CAREMARK ILLINOIS SPECIALTY PHARMACY, LLC DBA CAREMARK
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:
1134100134
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 99794
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60696-7594
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-225-5967
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 BIERMANN CT
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
MT PROSPECT
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60056-2151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-408-9742
Provider Business Practice Location Address Fax Number:
847-634-7400
Provider Enumeration Date:
11/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MARKOS
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT, TREASURER
Authorized Official Telephone Number:
800-225-5967

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  054016056 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X , with the licence number: 054016056 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X , with the licence number: 054016056 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336M0002X , with the licence number: 054016056 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X , with the licence number: 054016056 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 220388 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0244855 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5403150500 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1002401801 , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 886407100 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007362920036 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200072590A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 712020 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8535809 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0970517 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com