PROCARE PHARMACY, L.L.C. (NPI# 1093824575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093824575 |
| Entity Type | Organization |
| Organization Name | PROCARE PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY # 02553 |
| Practice Address |
1117 Walnut St Philadelphia PA 19107-4918 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 2156272143 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2016-06-28 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR PAYER RELATIONS) |
| Authorized Official Telephone | 4017651500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | PP410995L | PA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3976656 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy # 02553 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174921209 | Procare Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 10160 International Blvd, Westchester, OH 45246-4846 | 2014-12-05 |
| 1417100447 | Procare Pharmacy, L.L.C. | Pharmacy | 141 Preble St, Portland, ME 04101-2440 | 2008-11-04 |
| 1508975079 | Procare Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 445 Castro St, San Francisco, CA 94114-2019 | 2006-08-29 |
| 1225147796 | Procare Pharmacy, L.L.C. | Pharmacy | 1601 17th St Nw, Washington, DC 20009-2403 | 2006-08-29 |
| 1558470039 | Procare Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1309 Nw 23rd Ave, Portland, OR 97210-2601 | 2006-08-29 |
| 1942319413 | Procare Pharmacy, L.L.C. | Pharmacy | 4014 State Line Rd, Kansas City, KS 66103-3328 | 2006-08-29 |
| 1518039858 | Procare Pharmacy, L.L.C. | Pharmacy | 500 Ala Moana Blvd, Bldg 1 Ste A, Honolulu, HI 96813-4920 | 2006-11-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PROCARE PHARMACY, L.L.C. | 1 Cvs Drive, Legal Dept, Woonsocket, RI 02895 |
| Washington State Corporations | PROCARE PHARMACY, L.L.C. | 1 Cvs Drive, Woonsocket, RI 02895 |
| Connecticut Business Registrations | PROCARE PHARMACY, L.L.C. | One Cvs Dr, Woonsocket, RI 02895 |
| Iowa Business Entities | PROCARE PHARMACY, L.L.C. | One Cvs Drive, Woonsocket, RI 02895 |
| Colorado Business Entities | ProCare Pharmacy, L.L.C. | 1 Cvs Drive, Woonsocket, RI 02895 |
| New York State Corporations | PROCARE PHARMACY, L.L.C. | 1 Cvs Drive, Woonsocket, Ri 02895 |
| Vermont Business Registrations | PROCARE PHARMACY, L.L.C. | One Cvs Drive, Woonsocket, RI 02895 |
| Massachusetts Corporations | PROCARE PHARMACY, LLC | One Cvs Drive, C/o Cvs Pharmacy, Inc., Woonsocket, RI 02895 |
| Street Address |
1117 WALNUT ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-4918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942205836 | Michael Smikovecus | Pharmacist | 1117 Walnut St, Philadelphia, PA 19107-4918 | 2005-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912536517 | Hsjc LLC | Pharmacy | 4165 N Franklin St, Philadelphia, PA 19140-2207 | 2020-04-06 |
| 1750926119 | Dharm Nandan LLC | Pharmacy | 3808 Morrell Ave, Philadelphia, PA 19114-1915 | 2019-11-08 |
| 1871137208 | My Philadelphia Pharmacy Inc | Pharmacy | 2901 E Thompson St, Front Store, Philadelphia, PA 19134 | 2019-10-29 |
| 1346883451 | Dragon Pharmacy 99, LLC | Pharmacy | 2842 Saint Vincent St Unit A2, Philadelphia, PA 19149-1454 | 2019-10-21 |
| 1609417070 | Sdarbouze Apothecary Inc. | Pharmacy | 5751 N Broad St Ste 3, Philadelphia, PA 19141-2302 | 2019-10-07 |
| 1912550575 | Shwartz Rx 5610 Inc. | Pharmacy | 5610 Lancaster Ave Ste 200, Philadelphia, PA 19131-3440 | 2019-07-22 |
| 1487112405 | Sunray Chester LLC | Pharmacy | 5518 Chester Ave, Philadelphia, PA 19143-5328 | 2019-03-08 |
| 1669954210 | Wellmart Pharmacy Inc. | Pharmacy | 2363 E Allegheny Ave, Philadelphia, PA 19134-4431 | 2018-08-30 |
| 1902383185 | Tb Pharmacy Inc. | Pharmacy | 4931 N Broad St, Philadelphia, PA 19141-2215 | 2018-07-20 |
| 1154827103 | Gilead Pharmacy Inc | Pharmacy | 1226 N 52nd St Fl 1, Philadelphia, PA 19131-4315 | 2018-03-30 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.