Healthcare Provider Details

I. General information

NPI: 1518948413
Provider Name (Legal Business Name): CAREMARK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 PASSAIC AVE UNIT B-5
FAIRFIELD NJ
07004-3516
US

IV. Provider business mailing address

PO BOX 840688
DALLAS TX
75284-0688
US

V. Phone/Fax

Practice location:
  • Phone: 800-447-4791
  • Fax: 800-266-1644
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 Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00517800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number28RS00517800
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BRANDON MICHAEL AYCOCK
Title or Position: PRESIDENT
Credential:
Phone: 401-712-2782