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NPI Code Detail

MEDICARE: CAROMONT HEALTH RETAIL PHARMACY LLC

MEDICARE: CAROMONT HEALTH RETAIL 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
13336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1639058621
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROMONT HEALTH RETAIL PHARMACY LLC
Provider Business Mailing Address
First Line : 2525 COURT DR STE C
Second Line :
City : GASTONIA
State : NC
Zip : 28054-2140
Country : US
Telephone Number : 704-834-2098
Fax Number : 704-834-2581
Provider Business Practice Location Address
First Line : 2525 COURT DR
Second Line : SUITE C
City : GASTONIA
State : NC
Zip : 28054-2140
Country : US
Telephone Number : 704-834-2000
Fax Number :
Authorized Official
Title or Position : CFO
Name : DAVID O'CONNOR
Credential :
Telephone Number : 704-834-2127
Provider Enumeration Date : 09/02/2025
Last Update Date : 06/03/2026

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Directions to “CAROMONT HEALTH RETAIL PHARMACY LLC ” Practice Location

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