Provider Demographics
NPI:1508225335
Name:CARE MEDICA PHARMACY LLC
Entity Type:Organization
Organization Name:CARE MEDICA PHARMACY LLC
Other - Org Name:CARE MEDICA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH
Authorized Official - Prefix:
Authorized Official - First Name:NAVEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAMBUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-360-5930
Mailing Address - Street 1:110 BAUGHMANS LN
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4059
Mailing Address - Country:US
Mailing Address - Phone:301-360-5930
Mailing Address - Fax:301-360-5929
Practice Address - Street 1:110 BAUGHMANS LN
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4059
Practice Address - Country:US
Practice Address - Phone:301-360-5930
Practice Address - Fax:301-360-5929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-22
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MDP071153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2158967OtherPK