Provider Demographics
NPI:1902887805
Name:CAREMARK L.L.C.
Entity Type:Organization
Organization Name:CAREMARK L.L.C.
Other - Org Name:CVS/SPECIALTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-225-5967
Mailing Address - Street 1:PO BOX 99794
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60696-7594
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11162 RENNER BOULEVARD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-9621
Practice Address - Country:US
Practice Address - Phone:800-360-0520
Practice Address - Fax:909-799-4364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS209977332B00000X, 333600000X
332B00000X, 333600000X, 3336H0001X, 3336M0002X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0212979Medicaid
MO601353311Medicaid
IA0921122Medicaid
SD8533393Medicaid
WY116543700Medicaid
WY116543700Medicaid
MT0212979Medicaid
IA0921122Medicaid
IL=========014Medicaid