Healthcare Provider Details

I. General information

NPI: 1326029323
Provider Name (Legal Business Name): CAREMARK, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 09/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 N KALAHEO AVE STE C106 PALI PALMS PLAZA
KAILUA HI
96734-1866
US

IV. Provider business mailing address

PO BOX 840688
DALLAS TX
75284-0688
US

V. Phone/Fax

Practice location:
  • Phone: 800-834-8447
  • Fax: 808-254-6153
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 NumberPHY 663
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY633
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPHY663
License Number StateHI
# 4
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHY663
License Number StateHI

VIII. Authorized Official

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