Organization
CAREMAX MEDICAL RESOURCES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYANT MOSHANG (CONTROLLER)
(410) 910-1500
Entity
Organization
Contact information
Practice address
373 INVERNESS PKWY, SUITE 207, CENTENNIAL, CO 80112-5814
(303) 662-8383
Mailing address
13111 COLLECTION CENTER DR, CHICAGO, IL 60693-0131
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PDO-679
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0620244
NCPDP
CO
05
—
60981393
MEDICAID (PHARMACY)
CO
01
—
PDO-679
PHARMACY LICENSE
CO
Enumeration date
07/11/2007
Last updated
03/07/2023
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