Healthcare Provider Details

I. General information

NPI: 1124009121
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: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 WORLD TRADE BLVD. STE 110
RALEIGH NC
27617-4220
US

IV. Provider business mailing address

PO BOX 99794
CHICAGO IL
60696-7594
US

V. Phone/Fax

Practice location:
  • Phone: 919-474-6421
  • Fax: 919-799-4364
Mailing address:
  • Phone: 919-474-6421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number09934
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number09934
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number09934
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number09934
License Number StateNC

VIII. Authorized Official

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