Provider Demographics
NPI:1437408085
Name:CAREFREE COMPOUNDING & WELLNESS, LLC
Entity Type:Organization
Organization Name:CAREFREE COMPOUNDING & WELLNESS, LLC
Other - Org Name:CAREFREE COMPOUNDING & WELLNESS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MS
Authorized Official - First Name:LORICA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:YOCKEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:623-806-1300
Mailing Address - Street 1:34975 N NORTH VALLEY PARKWAY
Mailing Address - Street 2:STE 130
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086
Mailing Address - Country:US
Mailing Address - Phone:623-806-1300
Mailing Address - Fax:623-806-1304
Practice Address - Street 1:34975 N NORTH VALLEY PARKWAY
Practice Address - Street 2:STE 130
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086
Practice Address - Country:US
Practice Address - Phone:623-806-1300
Practice Address - Fax:623-806-1304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANRP-1857333600000X
333600000X, 3336C0003X, 3336C0004X
NVPH031983336C0003X
AZY0055243336C0003X
UT9108264-17083336C0003X
NMPH000037093336C0003X
WYNR-511593336C0003X
WINR-511593336C0003X
COOSP.00064853336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2136714OtherPK
AZ776708Medicaid