Provider Demographics
NPI:1285973842
Name:CAREMAX PHARMACY LLC
Entity type:Organization
Organization Name:CAREMAX PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KRISHNAKANT
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-551-9026
Mailing Address - Street 1:PO BOX 54668
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32245-4668
Mailing Address - Country:US
Mailing Address - Phone:904-551-9026
Mailing Address - Fax:904-758-3519
Practice Address - Street 1:2789 PARK ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-7607
Practice Address - Country:US
Practice Address - Phone:904-551-9026
Practice Address - Fax:904-758-3519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-01
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH265253336C0003X, 3336C0003X
3336L0003X, 3336S0011X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH26525OtherFLORIDA BOARD OFPHARMACY
FL6727740001Medicare NSC