Provider Demographics
NPI:1720352537
Name:CARE RX PHARMACY GROUP LLC
Entity Type:Organization
Organization Name:CARE RX PHARMACY GROUP LLC
Other - Org Name:CARE RX PHARMACY GROUP LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-326-5378
Mailing Address - Street 1:1485 LIVINGSTON LN
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39213-8004
Mailing Address - Country:US
Mailing Address - Phone:601-983-1239
Mailing Address - Fax:601-982-7103
Practice Address - Street 1:1865 W WOOLBRIGHT RD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6321
Practice Address - Country:US
Practice Address - Phone:561-336-2617
Practice Address - Fax:561-336-2619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH277123336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146493OtherPK