Provider Demographics
NPI:1043691694
Name:CAREFIRST SPECIALTY PHARMACY, LLC
Entity Type:Organization
Organization Name:CAREFIRST SPECIALTY PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:BHAVESH
Authorized Official - Middle Name:
Authorized Official - Last Name:THAKRAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:856-267-0528
Mailing Address - Street 1:2200 GARRY RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-2595
Mailing Address - Country:US
Mailing Address - Phone:856-267-0528
Mailing Address - Fax:856-267-0529
Practice Address - Street 1:2200 GARRY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2595
Practice Address - Country:US
Practice Address - Phone:856-267-0528
Practice Address - Fax:856-267-0529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS007402003336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy