Provider Demographics
NPI:1982665345
Name:MEDCARE, LLC
Entity Type:Organization
Organization Name:MEDCARE, LLC
Other - Org Name:MEDCARE PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FARIBORZ
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARFESHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:3014-975-6171
Mailing Address - Street 1:14900 SWEITZER LN
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-2915
Mailing Address - Country:US
Mailing Address - Phone:301-497-6171
Mailing Address - Fax:301-497-6191
Practice Address - Street 1:14900 SWEITZER LN
Practice Address - Street 2:SUITE 103
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-2915
Practice Address - Country:US
Practice Address - Phone:301-497-6171
Practice Address - Fax:301-497-6191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPW0224333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4707290001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER