Provider Demographics
NPI:1841271764
Name:CAREMARK, L.L.C.
Entity type:Organization
Organization Name:CAREMARK, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-799-4061
Mailing Address - Street 1:PO BOX 840688
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0688
Mailing Address - Country:US
Mailing Address - Phone:800-225-5967
Mailing Address - Fax:909-799-4364
Practice Address - Street 1:7034 ALAMO DOWNS PKWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-4509
Practice Address - Country:US
Practice Address - Phone:210-706-2200
Practice Address - Fax:210-706-2201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23826333600000X, 332B00000X
3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1841271764OtherPENNSYLVANIA STATE PROGRAMS: PACE, SPBP AND CRDP
TXPH0392OtherMEDICARE B
NJ0191159OtherNEW JERSEY STATE ASSISTANCE: PAAD, SENIOR GOLD, ADDP & CYSTIC FIBROSIS
NJ0191159Medicaid
NJ0191159Medicaid