Healthcare Provider Details

I. General information

NPI: 1114189206
Provider Name (Legal Business Name): CAREMARK, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 MALLARD ST STE. C
SAINT ROSE LA
70087-4020
US

IV. Provider business mailing address

PO BOX 840688
DALLAS TX
75284-0688
US

V. Phone/Fax

Practice location:
  • Phone: 800-571-3996
  • Fax: 866-540-7707
Mailing address:
  • Phone: 800-225-5967
  • Fax: 909-799-4364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

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