Provider Demographics
NPI:1205175510
Name:DELIVERCARERX PHARMACY, LLC
Entity type:Organization
Organization Name:DELIVERCARERX PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISHNA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:847-965-1600
Mailing Address - Street 1:1471 E. BUSINESS CENTER DRIVE
Mailing Address - Street 2:STE 200
Mailing Address - City:MT. PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056
Mailing Address - Country:US
Mailing Address - Phone:847-965-1600
Mailing Address - Fax:847-965-1611
Practice Address - Street 1:1471 E. BUSINESS CENTER DRIVE
Practice Address - Street 2:STE 200
Practice Address - City:MT. PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056
Practice Address - Country:US
Practice Address - Phone:847-965-1600
Practice Address - Fax:847-965-1611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
IL3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
6824550001Medicare NSC