Provider Demographics
NPI:1417061409
Name:CARE TEAM LC
Entity Type:Organization
Organization Name:CARE TEAM LC
Other - Org Name:APOTHECARY SHOP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNORR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:512-345-1444
Mailing Address - Street 1:11645 ANGUS RD
Mailing Address - Street 2:STE 1
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4100
Mailing Address - Country:US
Mailing Address - Phone:512-345-1444
Mailing Address - Fax:512-345-7721
Practice Address - Street 1:11645 ANGUS RD
Practice Address - Street 2:STE 1
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4100
Practice Address - Country:US
Practice Address - Phone:512-345-1444
Practice Address - Fax:512-345-7721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX242843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144046Medicaid
2101222OtherPK