Provider Demographics
NPI:1417280595
Name:CAPITAL CARE RX LLC
Entity Type:Organization
Organization Name:CAPITAL CARE RX LLC
Other - Org Name:BRIER CREEK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RITESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-219-2006
Mailing Address - Street 1:10410 MONCREIFFE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7832
Mailing Address - Country:US
Mailing Address - Phone:919-361-4343
Mailing Address - Fax:919-361-4332
Practice Address - Street 1:10410 MONCREIFFE RD STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-7821
Practice Address - Country:US
Practice Address - Phone:919-361-4343
Practice Address - Fax:919-361-4332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3417246OtherNCPDP PROVIDER IDENTIFICATION NUMBER