CCR LLC (NPI# 1609306919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609306919 |
| Entity Type | Organization |
| Organization Name | CCR LLC |
| Other Organization Name | JB PHARMACY |
| Practice Address |
1017 Smith St Providence RI 02908-2747 |
| Mailing Address |
1017 Smith St Providence RI 02908 |
| Practice Telephone | 4018611194 |
| Practice Fax Number | 4013837773 |
| Mailing Telephone | 4018611194 |
| Mailing Fax Number | 4013837773 |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2017-06-19 |
| Authorized Official Name | PAUL CAPUANO (PHARMACIST/OWNER) |
| Authorized Official Telephone | 4018611194 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
PHA00542 | RI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | JP68164 | 05 | |
| PK | 2169883 | 01 |
| Other Name | Type Code |
|---|---|
| JB Pharmacy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | CCR LLC | 1606 heathcliff road, High Point, NC 27262 |
| Street Address |
1017 SMITH ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02908-2747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518153014 | Ccr Pharmacy LLC | Pharmacy | 1017 Smith St, Providence, RI 02908-2747 | 2007-09-18 |
| 1386270601 | Aj Pharmacy LLC | Pharmacy | 1017 Smith St, Providence, RI 02908-2747 | 2020-03-18 |
| 1851926364 | Charles Agwunobi | Pharmacist | 1017 Smith St, Providence, RI 02908-2747 | 2020-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548771900 | Horizon Wellness | Clinic/Center | 1339 Smith St, North Providence, RI 02908 | 2017-10-12 |
| 1477098069 | Beth Perry | Nurse Practitioner | 830 Chalstone Ave., Providence, RI 02908 | 2017-01-05 |
| 1659788735 | Brandi Kimble | Podiatrist | 825 Chalkstone Avenue, Providence, RI 02908 | 2014-07-21 |
| 1912253675 | Roger Williams Medical Center | Long Term Care Hospital | 25 Chalkstone Ave, Providence, RI 02908 | 2012-07-31 |
| 1669768818 | Elisa Semedo | Physical Therapist | 285 Promenade Street, Providence, RI 02908 | 2011-06-27 |
| 1255655502 | Caregiver Homes of Rhode Island Inc. | Custodial Care Facility | 235 Promenade Street, Providence, RI 02908 | 2010-03-16 |
| 1487884987 | Professional Ambulance LLC | Ambulance | 52 River Ave, Providence, RI 02908 | 2009-07-17 |
| 1609065804 | Stephen W Davis | Family Medicine | 299 Promenade Street, Nhpri, Providence, RI 02908 | 2007-10-24 |
| 1205053899 | John R Ricci | Dentist | 1252 Smith St, Providence, RI 02908 | 2007-04-18 |
| 1871718718 | Brett C Auclaire | Nurse Practitioner | 40 Candace Street, Providence, RI 02908 | 2007-04-16 |
| Find all providers in zip 02908 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053975102 | Green Line Apothecary of Providence LLC | Pharmacy | 905 N Main St, Providence, RI 02904-5744 | 2019-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871125047 | Personifilrx New England, LLC | Pharmacy | 225 Metro Center Blvd, Warwick, RI 02886-1783 | 2020-02-06 |
| 1306297098 | Woodmark Pharmacy of Rhode Island, LLC | Pharmacy | 114 Minnesota Ave, Warwick, RI 02888-6026 | 2016-06-24 |
| 1437282803 | Pawtuxet Valley Prescription & Surgical Center,inc | Pharmacy | 65 Sandy Bottom Rd, Coventry, RI 02816-5863 | 2007-03-14 |
| 1447320056 | Asco Healthcare of New England Limited Partnership | Pharmacy | 30 Centre of New England Blvd, Coventry, RI 02816-6068 | 2006-11-09 |
| 1740820984 | Mcquade's Marketplace Pharmacy | Pharmacy | 106 Main St., Westerly, RI 02891 | 2020-01-15 |
| 1225695760 | Casmer | Pharmacy | 113 Frenchtown Road, North Kingstown, RI 02852 | 2019-05-21 |
| 1821572280 | Simpson's Pharmacy | Pharmacy | 10 Newport Ave, Pawtucket, RI 02861-4497 | 2018-09-21 |
| 1174843544 | Genoa Healthcare, LLC | Pharmacy | 4705 Old Post Rd Unit A, Charlestown, RI 02813-1842 | 2010-06-08 |
| 1639380553 | Genoa Healthcare, LLC | Pharmacy | 103 Bacon St, Pawtucket, RI 02860-5542 | 2007-05-24 |
| 1255416541 | Quality Pharmaceutical Services | Pharmacy | 1130 Ten Rod Rd, Ste F101, North Kingstown, RI 02852-4161 | 2006-10-26 |
| Find all providers with the same taxonomy | ||||
| City | PROVIDENCE |
| Zip Code | 02908 |
Please comment or provide details below to improve the information on CCR LLC.
| 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.