Healthcare Provider Details

I. General information

NPI: 1184605099
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: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 ALLEN DR STE H
TROY MI
48083
US

IV. Provider business mailing address

1307 ALLEN DR STE H
TROY MI
48083-4010
US

V. Phone/Fax

Practice location:
  • Phone: 248-968-6000
  • Fax: 800-753-2777
Mailing address:
  • Phone: 248-968-6000
  • Fax: 248-968-8000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number5301008134
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number5301008134
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5301008134
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number5301008134
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number5301008134
License Number StateMI

VIII. Authorized Official

Name: BRANDON MICHAEL AYCOCK
Title or Position: PRESIDENT
Credential:
Phone: 901-438-8738