Provider Demographics
NPI:1598058273
Name:CARE ONE PHARMACY SERVICES LLC
Entity type:Organization
Organization Name:CARE ONE PHARMACY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEYMOUR
Authorized Official - Middle Name:
Authorized Official - Last Name:GERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-674-2600
Mailing Address - Street 1:3855 OAKTON ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3429
Mailing Address - Country:US
Mailing Address - Phone:847-674-2600
Mailing Address - Fax:847-674-2550
Practice Address - Street 1:3855 OAKTON ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3429
Practice Address - Country:US
Practice Address - Phone:847-674-2600
Practice Address - Fax:847-674-2550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X, 333600000X
IL0540175733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2130520OtherPK