Healthcare Provider Details

I. General information

NPI: 1386326452
Provider Name (Legal Business Name): CAREMAX PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 COLLEGE ST STE D
BATTLE CREEK MI
49037-3461
US

IV. Provider business mailing address

126 COLLEGE ST STE D
BATTLE CREEK MI
49037-3461
US

V. Phone/Fax

Practice location:
  • Phone: 313-674-7471
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SHAMSAN AL-MANSOOB
Title or Position: OWNER/MANAGER
Credential:
Phone: 313-674-7471