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NPI Code Detail

MEDICARE: CARE RX PHARMACY GROUP LLC

MEDICARE: CARE RX PHARMACY GROUP 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 PharmacyPH27712FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12146493OTHERPK

General Provider Information

NPI Number : 1720352537
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARE RX PHARMACY GROUP LLC
Provider Business Mailing Address
First Line : 1485 LIVINGSTON LN
Second Line :
City : JACKSON
State : MS
Zip : 39213-8004
Country : US
Telephone Number : 601-983-1239
Fax Number : 601-982-7103
Provider Business Practice Location Address
First Line : 1865 W WOOLBRIGHT RD
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33426-6321
Country : US
Telephone Number : 561-336-2617
Fax Number : 561-336-2619
Authorized Official
Title or Position : MANAGER
Name : CHAD BARRETT
Credential :
Telephone Number : 601-326-5378
Provider Enumeration Date : 02/27/2012
Last Update Date : 09/17/2015

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