Organization
PROCARE PHARMACY DIRECT, LLC.
Active
Other names
CVS Specialty
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON AYCOCK (PRESIDENT)
(401) 765-1500
Entity
Organization
Contact information
Practice address
105 MALL BLVD, MONROEVILLE, PA 15146-2230
(800) 238-7828
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 770-7240
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
PP414230L
PA
3336S0011X
Specialty Pharmacy
Primary
PP-414230-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007692930010
—
PA
Enumeration date
11/14/2006
Last updated
12/10/2025
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