NPIMap

Organization Active NPI

Procare Pharmacy, LLC.

Doing business as CVS Pharmacy #02909

  • Specialty Pharmacy
  • Birmingham, AL
National Provider Identifier
1578635819
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
111798 Issued in AL
Legal business name
PROCARE PHARMACY, LLC.
Doing business as
CVS Pharmacy #02909
Practice address
1521 4TH Ave S
Birmingham, AL 35233-1612
Phone
(800) 598-8053
NPI assigned
Nov 14, 2006
Last updated
Dec 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brandon M Aycock
Title
President
Phone
(401) 765-1500

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X NU
Specialty Pharmacy 3336S0011X 111798 AL Primary

Addresses

Primary practice location

1521 4TH Ave S
Birmingham, AL 35233-1612

Mailing address

1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 1

IdentifierTypeStateIssuer
100003194MedicaidAL

Other names 1

  • CVS Pharmacy #02909 Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930091512 AL DME Supplier - Pharmacy 5496643652 Practice locations: Birmingham, AL
O20221010000564 AL Part B Supplier - Pharmacy 5496643652 Practice locations: Birmingham, AL

Other NPIs with the same Medicare PAC ID 21

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 21

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Careplus CVS/Pharmacy # 29091521 4TH S Ave, Birmingham, AL 35233-1612(800) 598-8053 Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… Accepts assignmentParticipating since Jan 1, 2023

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations (25 of 29)

1521 4th Ave S
Birmingham, AL 35233
Phone (205) 290-9577

1002 E McDowell Rd
#3129
Phoenix, AZ 85006
Phone (602) 258-7051

3031 Telegraph Ave
Ste 115
Berkeley, CA 94705
Phone (510) 841-2211

445 Castro St
San Francisco, CA 94114
Phone (415) 864-7030

2101 N Ursula St
Unit 35
Aurora, CO 80045
Phone (303) 364-1139

1604 E 17th Ave
Denver, CO 80218
Phone (303) 388-7504

656 NE 125th St
North Miami, FL 33161
Phone (305) 899-0990

2600 N Orange Ave
Orlando, FL 32804
Phone (407) 896-8917

417 S Hyde Park Ave
Tampa, FL 33606
Phone (813) 251-2039

2581 Metrocentre Blvd
Ste 1
West Palm Beach, FL 33407
Phone (305) 835-4912

560 Amsterdam Ave NE
Atlanta, GA 30306
Phone (404) 892-9131

560 Amsterdam Ave NE
Ste E
Atlanta, GA 30306
Phone (404) 891-9131

3375 Koapaka St
Ste D105
Honolulu, HI 96819
Phone (800) 896-1464

500 Ala Moana Blvd
Bldg 1
Honolulu, HI 96813
Phone (775) 237-3524

500 Ala Moana Blvd
Ste 1A
Honolulu, HI 96813
Phone (800) 896-1464

970 N Kalaheo Ave
Kailua, HI 96734
Phone (808) 254-2727

350 Longwood Ave
Ste B
Boston, MA 02115
Phone (617) 731-8665

123 Summer St
Ste 360
Worcester, MA 01608
Phone (508) 368-3171

6 Pine Tree Dr
Ste 290
Saint Paul, MN 55112
Phone (651) 481-1089

32 N Euclid Ave
Saint Louis, MO 63108
Phone (314) 454-1214

601 S Kings Dr
Charlotte, NC 28204
Phone (704) 333-7435

892 9th Ave
New York, NY 10019
Phone (212) 445-0932

80 Air Park Dr
#292
Ronkonkoma, NY 11779
Phone (631) 981-0034

10160 International Blvd
West Chester, OH 45246
Phone (513) 860-1573

538 SW 4th Ave
Portland, OR 97204
Phone (503) 226-2222

Practitioners & affiliated clinicians

Practitioners 78

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 78

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1578635819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500",
            "fax_number": "401-735-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 4TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331612",
            "telephone_number": "800-598-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE PHARMACY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "AYCOCK",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-765-1500"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "AL",
            "license": "111798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003194",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St #900a,",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #02909",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CVS Pharmacy #02909",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.