Provider Demographics
NPI:1326284894
Name:CARE RX LLC
Entity Type:Organization
Organization Name:CARE RX LLC
Other - Org Name:PROPAC PAYLESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AJ
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-330-3665
Mailing Address - Street 1:18110 SE 34TH ST
Mailing Address - Street 2:BLDG 2 STE 270
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-9418
Mailing Address - Country:US
Mailing Address - Phone:800-330-3665
Mailing Address - Fax:800-982-2730
Practice Address - Street 1:2411 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5824
Practice Address - Country:US
Practice Address - Phone:503-626-9436
Practice Address - Fax:800-982-2730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
ORRP-0002524-CS3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500611485Medicaid
2118501OtherPK