Organization
PROCARE PHARMACY, L.L.C.
Active
Other names
CarePlus CVS/pharmacy 02858
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTIANA MAURICIO (MGR PHCY ENROLLMENTS)
(401) 770-2937
Entity
Organization
Contact information
Practice address
4014 STATE LINE RD, KANSAS CITY, KS 66103-3328
(913) 262-1190
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
2-09992
KS
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1718507
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
1942319413
DME
MO
05
—
1942319413
—
MO
Enumeration date
08/29/2006
Last updated
12/09/2008
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