Healthcare Provider Details

I. General information

NPI: 1821170366
Provider Name (Legal Business Name): CARE RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 LORRAINE AVE
STOCKTON CA
95210-4203
US

IV. Provider business mailing address

18110 SE 34TH ST STE 270
VANCOUVER WA
98683-9440
US

V. Phone/Fax

Practice location:
  • Phone: 209-957-8787
  • Fax: 209-951-1456
Mailing address:
  • Phone: 800-330-3665
  • Fax: 800-982-2730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number54574
License Number StateCA

VIII. Authorized Official

Name: JOHN MACK
Title or Position: CEO
Credential:
Phone: 800-330-3665