MEDICARE: CAREMAX 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	3336C0003X	Community/Retail Pharmacy	PH26525	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PH26525	OTHER	FL	FLORIDA BOARD OFPHARMACY

General Provider Information

NPI Number	:	1285973842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREMAX PHARMACY LLC

Provider Business Mailing Address
First Line	:	PO BOX 600489
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32260-0489
Country	:	US
Telephone Number	:	904-551-9026
Fax Number	:	904-758-3519

Provider Business Practice Location Address
First Line	:	2789 PARK ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-7607
Country	:	US
Telephone Number	:	904-551-9026
Fax Number	:	904-758-3519

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. VIPUL MAMTORA
Credential	:
Telephone Number	:	904-551-9026

Provider Enumeration Date	:	02/01/2013
Last Update Date	:	12/15/2025

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Directions to “CAREMAX PHARMACY LLC ” Practice Location

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