Provider Demographics
NPI:1003299967
Name:CARESMART PHARMACY 1, LLC
Entity Type:Organization
Organization Name:CARESMART PHARMACY 1, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YULIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-972-8959
Mailing Address - Street 1:2955 SW 8TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2862
Mailing Address - Country:US
Mailing Address - Phone:305-972-8952
Mailing Address - Fax:
Practice Address - Street 1:2955 SW 8TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2862
Practice Address - Country:US
Practice Address - Phone:305-972-8952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH292083336C0003X
FLPH292113336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy