Provider Demographics
NPI:1417596511
Name:CAREMARK L.L.C.
Entity Type:Organization
Organization Name:CAREMARK L.L.C.
Other - Org Name:CVS SPECIALTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-799-4061
Mailing Address - Street 1:1127 BRYN MAWR AVE STE A
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4558
Mailing Address - Country:US
Mailing Address - Phone:909-799-4174
Mailing Address - Fax:909-799-4364
Practice Address - Street 1:7251 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4507
Practice Address - Country:US
Practice Address - Phone:866-833-3752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAREMARK RX, L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-06
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy