Provider Demographics
NPI:1942670831
Name:DELIVERCARERX PHARMACY LLC
Entity Type:Organization
Organization Name:DELIVERCARERX PHARMACY LLC
Other - Org Name:DELIVERCARERX PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISHNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-965-1600
Mailing Address - Street 1:1471 E BUSINESS CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-6058
Mailing Address - Country:US
Mailing Address - Phone:855-965-1600
Mailing Address - Fax:855-713-2340
Practice Address - Street 1:1471 E BUSINESS CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-6058
Practice Address - Country:US
Practice Address - Phone:855-965-1600
Practice Address - Fax:855-713-2340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PANP000018333600000X
3336C0003X
IL054.0181623336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154329OtherPK