MEDICARE: CAREMARK L.L.C.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3336C0004X	Compounding Pharmacy
2	3336C0003X	Community/Retail Pharmacy
3	3336H0001X	Home Infusion Therapy Pharmacy
4	332B00000X	Durable Medical Equipment & Medical Supplies
5	3336S0011X	Specialty Pharmacy

General Provider Information

NPI Number	:	1417596511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREMARK L.L.C.

Provider Business Mailing Address
First Line	:	1127 BRYN MAWR AVE STE A
Second Line	:
City	:	REDLANDS
State	:	CA
Zip	:	92374-4558
Country	:	US
Telephone Number	:	909-799-4174
Fax Number	:	909-799-4364

Provider Business Practice Location Address
First Line	:	7251 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4507
Country	:	US
Telephone Number	:	866-833-3752
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRANDON AYCOCK
Credential	:
Telephone Number	:	800-746-7287

Provider Enumeration Date	:	01/06/2020
Last Update Date	:	12/09/2025

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Directions to “CAREMARK L.L.C. ” Practice Location

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