Provider Demographics
NPI:1619536240
Name:CAREPARTNERS PHARMACY LLC
Entity Type:Organization
Organization Name:CAREPARTNERS PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:KAMYAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAZVINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-294-1199
Mailing Address - Street 1:326 PETERSON RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-1008
Mailing Address - Country:US
Mailing Address - Phone:224-294-1199
Mailing Address - Fax:224-433-6862
Practice Address - Street 1:326 PETERSON RD
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-1008
Practice Address - Country:US
Practice Address - Phone:224-294-1199
Practice Address - Fax:224-433-6862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL054021250OtherIL BOARD OF PHARMACY