PROCARE PHARMACY LLC (NPI# 1205930104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205930104 |
| Entity Type | Organization |
| Organization Name | PROCARE PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #00102 |
| Practice Address |
2101 N Ursula St Unit 35 Aurora CO 80045-7426 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 8668134547 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2016-06-29 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | PDO617 | CO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | NM MEDICAID (RX) | 33383341 | 01 |
| WY | WY MEDICAID (RX) | 135307100 | 01 |
| OK | 200125790B | 05 | |
| MT | MT MEDICAID (RX) | 1205930104 | 01 |
| UT | 1205930104 | 05 | |
| NE | 10025711800 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0619479 | 01 | |
| CO | 32920768 (DME) | 05 | |
| CO | 09981756 (RX) | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #00102 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669549580 | Procare Pharmacy LLC | Clinical Medical Laboratory | 6 Pinetree Dr, Ste 290 Northpark Center, Arden Hills, MN 55112 | 2006-11-29 |
| 1013089382 | Procare Pharmacy LLC | Pharmacy | 1001 Madison St, Seattle, WA 98104-1263 | 2006-11-14 |
| 1003925587 | Procare Pharmacy LLC | Pharmacy | 126 8th Ave, New York, NY 10011-5108 | 2006-08-29 |
| 1760591234 | Procare Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 35 Kneeland St, Boston, MA 02111-1523 | 2006-08-29 |
| 1962511436 | Procare Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1010 University Ave, San Diego, CA 92103-3398 | 2006-08-29 |
| 1720197205 | Procare Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2 Dudley St Ste 170, Providence, RI 02905-3246 | 2006-08-29 |
| 1407965973 | Procare Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8607 Santa Monica Blvd, West Hollywood, CA 90069-4109 | 2006-08-29 |
| 1215046784 | Procare Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 560 Amsterdam Ave Ste E, Atlanta, GA 30306-3479 | 2006-08-29 |
| 1396785861 | Procare Pharmacy LLC | Pharmacy | 11 S Eutaw St, Baltimore, MD 21201 | 2006-06-06 |
| 1366436057 | Procare Pharmacy LLC | Pharmacy | 538 Sw 4th Ave, Portland, OR 97204-2102 | 2005-09-08 |
| Street Address |
2101 N URSULA ST UNIT 35 |
| City | AURORA |
| State | CO |
| Zip Code | 80045-7426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942817408 | Salwa Mourtada Bamba | Nurse Practitioner | University of Colorado Medicine, 12631 East 17th Avenue, Aurora, CO 80045 | 2020-09-29 |
| 1114545233 | Chun Cheong Tsui | Student in an Organized Health Care Education/Training Program | 12801 E. 17th Avenue, Ms 8117, Aurora, CO 80045 | 2020-07-07 |
| 1487278719 | James Charles Tuka IIi | Social Worker | 1700 North Wheeling, Aurora, CO 80045 | 2020-06-02 |
| 1427677806 | Justin Yu | Student in an Organized Health Care Education/Training Program | 12631 E. 17th Ave. Ms B205, Aurora, CO 80045 | 2020-04-15 |
| 1558980011 | Erik Von Polsdofer | Student in an Organized Health Care Education/Training Program | Academic Office 1; Department of Pathology, 12631 East 17th Avenue, Aurora, CO 80045 | 2020-04-14 |
| 1831718568 | Luke Porter Bacon | Student in an Organized Health Care Education/Training Program | 3001 East 17th Place, Aurora, CO 80045 | 2020-04-13 |
| 1366061368 | Hilary Novatt | Student in an Organized Health Care Education/Training Program | 12631 E 17th Ave, B198-6, Room 4007, Aurora, CO 80045 | 2020-04-10 |
| 1376195362 | Katie Tuck | Pharmacist | 1700 North Wheeling Street (119), Fs-111o, Aurora, CO 80045 | 2019-07-10 |
| 1518529130 | Ronak Kamal Kapadia | Student in an Organized Health Care Education/Training Program | 12700 E. 19th Ave, Ms B182 Rm 5104, Aurora, CO 80045 | 2019-07-03 |
| 1245898253 | Rasha Elbadry Ahmed | Student in an Organized Health Care Education/Training Program | Childrens Hospital Colorado Pediatric Neurosurgery, 13123e. 16th Ave, B330, Aurora, CO 80045 | 2019-06-04 |
| Find all providers in zip 80045 | ||||
| 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 |
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| 1891305108 | Apex Pharmacy LLC | Pharmacy | 12597 E Mississippi Ave Unit 300, Aurora, CO 80012-3460 | 2020-08-03 |
| 1144681354 | Benivex Inc | Pharmacy | 370 W Indian Trl, Aurora, IL 60506-2451 | 2016-03-15 |
| 1366889115 | Grace Health Pharmacy | Pharmacy | 3191 S Vaughn Way Unit 102, Unit 102, Aurora, CO 80014-3505 | 2013-06-03 |
| 1326330358 | Terrascripts LLC | Pharmacy | 13801 E Yale Ave Unit 119, Aurora, CO 80014-2339 | 2011-05-10 |
| 1992004766 | Highland Pharmacy Inc | Pharmacy | 1177 N. Highland Ave, Suite 203, Aurora, IL 60506 | 2011-03-19 |
| 1114221751 | Medshop Pharmacy LLC | Pharmacy | 3535 E New York St, Aurora, IL 60504-4465 | 2010-12-22 |
| 1255591780 | Metro Community Provider Network, Inc. | Pharmacy | 3292 Peoria Street, Aurora, CO 80110-1517 | 2008-06-09 |
| 1689833097 | Walgreen Co | Pharmacy | 15310 E Colfax Ave, Aurora, CO 80011-5806 | 2008-06-02 |
| 1114098126 | Rpcs, Inc | Pharmacy | 708 S Elliott Ave, Aurora, MO 65605-2210 | 2006-11-13 |
| 1407957848 | Family Pharmacy Inc | Pharmacy | 1718 S Chambers Rd, Aurora, CO 80017-5023 | 2006-09-26 |
| Find all providers in AURORA | ||||
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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.