MEDICARE: CAREMOR PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy

General Provider Information

NPI Number	:	1285104620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREMOR PHARMACY LLC

Provider Business Mailing Address
First Line	:	1670 W PRATT BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-4105
Country	:	US
Telephone Number	:	609-772-1314
Fax Number	:

Provider Business Practice Location Address
First Line	:	3839 N WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3733
Country	:	US
Telephone Number	:	773-739-9036
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMED MURSHED
Credential	:
Telephone Number	:	609-772-1314

Provider Enumeration Date	:	11/28/2018
Last Update Date	:	11/28/2018

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