Provider Demographics
NPI:1033620604
Name:CARE-FILL LTC INC
Entity Type:Organization
Organization Name:CARE-FILL LTC INC
Other - Org Name:CARE-FILL LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETTON
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:WALBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-612-2131
Mailing Address - Street 1:260 DONATION RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16125-8008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28 CONNEAUT LAKE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-2167
Practice Address - Country:US
Practice Address - Phone:724-588-6337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP482755333600000X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy