Provider Demographics
NPI:1114095874
Name:CONTINUUMCARE PHARMACY LLC
Entity Type:Organization
Organization Name:CONTINUUMCARE PHARMACY LLC
Other - Org Name:CONTINUUMCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CANERIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-627-7100
Mailing Address - Street 1:74 PERRY WINKLE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702-9506
Mailing Address - Country:US
Mailing Address - Phone:304-736-4608
Mailing Address - Fax:304-736-2456
Practice Address - Street 1:1100 CENTRAL AVE
Practice Address - Street 2:1ST FLR
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-4011
Practice Address - Country:US
Practice Address - Phone:513-422-7705
Practice Address - Fax:513-422-9238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0218554003336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3673539OtherNCPDP PROVIDER IDENTIFICATION NUMBER