Provider Demographics
NPI:1740261643
Name:CAREMARK, L.L.C.
Entity type:Organization
Organization Name:CAREMARK, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:GOLDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-225-5967
Mailing Address - Street 1:PO BOX 840688
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0688
Mailing Address - Country:US
Mailing Address - Phone:800-225-5967
Mailing Address - Fax:909-799-4364
Practice Address - Street 1:500 BUSINESS CENTER DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-1333
Practice Address - Country:US
Practice Address - Phone:888-285-4287
Practice Address - Fax:412-490-0645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2010-01-28
Deactivation Date:2009-11-09
Deactivation Code:
Reactivation Date:2010-01-28
Provider Licenses
StateLicense IDTaxonomies
PAPP415279L332B00000X, 333600000X, 3336H0001X, 3336M0002X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0141542000Medicaid
MD234410600Medicaid
KY5400378500Medicaid
OH2119424Medicaid
PA1007362920037Medicaid
NJ7466501Medicaid
063485Medicare ID - Type UnspecifiedPART B
WV0141542000Medicaid