MEDICARE: CARECENTER PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	TX
2	3336C0003X	Community/Retail Pharmacy	TX
3	333600000X	Pharmacy	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4553447	OTHER	TX	NCPDP
2	217577001	OTHER	TX	DME
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700017886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARECENTER PHARMACY LLC

Provider Business Mailing Address
First Line	:	1 CVS DR
Second Line	:	BOX 1075 - PHARMACY ENROLLMENTS
City	:	WOONSOCKET
State	:	RI
Zip	:	02895-6146
Country	:	US
Telephone Number	:	401-765-1500
Fax Number	:	401-770-7108

Provider Business Practice Location Address
First Line	:	208 S AKARD ST # PC08
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75202-4206
Country	:	US
Telephone Number	:	214-741-4912
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, PAYER RELATIONS
Name	:	SUSAN COLBERT
Credential	:
Telephone Number	:	401-770-2751

Provider Enumeration Date	:	08/06/2009
Last Update Date	:	07/21/2022

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Directions to “CARECENTER PHARMACY LLC ” Practice Location

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