Provider Demographics
NPI:1396842233
Name:CARE PHARMACY LLC
Entity Type:Organization
Organization Name:CARE PHARMACY LLC
Other - Org Name:CARE PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCHAL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:843-545-9292
Mailing Address - Street 1:1111 MEMORIAL LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29440-3311
Mailing Address - Country:US
Mailing Address - Phone:843-545-9292
Mailing Address - Fax:843-520-4345
Practice Address - Street 1:718 N FRASER ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-3353
Practice Address - Country:US
Practice Address - Phone:843-545-9292
Practice Address - Fax:843-520-4345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X, 3336L0003X, 3336L0003X
SC67493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2092250OtherPK
SCDE2234Medicaid
SCDE2234Medicaid