CAREMARK, L.L.C.

Provider Demographics

• NPI: 1013998921
• Name: CAREMARK, L.L.C.
• Entity Type: Organization
• Organization Name: CAREMARK, L.L.C.
• Other - Org Name: CVS/SPECIALTY
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: PRESIDENT
• Authorized Official - First Name: MARIA
• Authorized Official - Last Name: MARKOS
• Authorized Official - Phone: 401-770-3303
• Mailing Address - Street 1: PO BOX 99794
• Mailing Address - City: CHICAGO
• Mailing Address - State: IL
• Mailing Address - Zip Code: 60696-7594
• Mailing Address - Country: US
• Mailing Address - Phone: 909-799-7171
• Mailing Address - Fax: 919-799-4364
• Practice Address - Street 1: 1127 BRYN MAWR AVE.
• Practice Address - Street 2: STE A
• Practice Address - City: REDLANDS
• Practice Address - State: CA
• Practice Address - Zip Code: 92374-4558
• Practice Address - Country: US
• Practice Address - Phone: 909-799-7171
• Practice Address - Fax: 909-799-4364
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2005-11-08
• Last Update Date: 2023-06-29

Provider Licenses

State	License ID	Taxonomies
CA	PHY39314	332B00000X, 333600000X, 3336H0001X, 3336S0011X
		332B00000X, 333600000X, 3336H0001X, 3336S0011X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	3336S0011X	Suppliers	Pharmacy	Specialty Pharmacy
No	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies
No	333600000X	Suppliers	Pharmacy
No	3336H0001X	Suppliers	Pharmacy	Home Infusion Therapy Pharmacy

Provider Identifiers

State	Identifier ID	ID Type	Issuer
IN	100121500A	Medicaid
NV	2889031	Medicaid
MI	0591796	Medicaid
MN	648357700	Medicaid
NY	01104241	Medicaid
MT	1013998921	Medicaid
MD	505282300	Medicaid
NJ	5589207	Medicaid
AK	PH335CA	Medicaid
CA	PHA393140	Other	STATE CHILDREN'S PROGRAM
ID	003522200	Medicaid
MA	0436283	Medicaid
IL	1013998921	Medicaid
CO	64251331	Medicaid
IA	1013998921	Medicaid
KY	5402384100	Medicaid
NM	56913	Medicaid
NM	56913	Medicaid
CA	PHA393140	Other	STATE CHILDREN'S PROGRAM
NY	01104241	Medicaid