Provider Demographics
NPI:1134265564
Name:CARE OPTIONS RX LLC
Entity type:Organization
Organization Name:CARE OPTIONS RX LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:GOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:717-486-8606
Mailing Address - Street 1:219 N BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17065-1204
Mailing Address - Country:US
Mailing Address - Phone:717-486-8606
Mailing Address - Fax:717-486-4410
Practice Address - Street 1:940 OAK OVAL
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-8410
Practice Address - Country:US
Practice Address - Phone:717-796-3611
Practice Address - Fax:717-796-3621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP481380183500000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007385460016Medicaid