Healthcare Provider Details

I. General information

NPI: 1750362653
Provider Name (Legal Business Name): CAREMARKPCS ALABAMA MAIL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 MILAN CT
BIRMINGHAM AL
35211-6919
US

IV. Provider business mailing address

PO BOX 840688
DALLAS TX
75284-0688
US

V. Phone/Fax

Practice location:
  • Phone: 205-769-4000
  • Fax: 205-769-4983
Mailing address:
  • Phone: 800-225-5967
  • Fax: 909-799-4364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number111574
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number111574
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number111574
License Number StateAL

VIII. Authorized Official

Name: MR. DAVID W GOLDING
Title or Position: VICE PRESIDEN
Credential:
Phone: 800-225-5967