NPIMap

Organization Active NPI

Procare Pharmacy, L.L.C.

Doing business as CarePlus CVS/pharmacy 02858

  • Pharmacy
  • Kansas City, KS
National Provider Identifier
1942319413
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
2-09992 Issued in KS
Legal business name
PROCARE PHARMACY, L.L.C.
Doing business as
CarePlus CVS/pharmacy 02858
Practice address
4014 State Line Rd
Kansas City, KS 66103-3328
Phone
(913) 262-1190
NPI assigned
Aug 29, 2006
Last updated
Dec 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

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

Authorized official

Name
Cristiana Mauricio
Title
MGR Phcy Enrollments
Phone
(401) 770-2937

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 2-09992 KS Primary
Community/Retail Pharmacy 3336C0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

4014 State Line Rd
Kansas City, KS 66103-3328

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
1942319413MedicaidMO
1942319413OtherMODME
1718507OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • CarePlus CVS/pharmacy 02858 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CVS Pharmacy 0281914 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

4014 State Line Rd
Kansas City, KS 66103
Phone (913) 262-1190

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1942319413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "PO BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 STATE LINE RD",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661033328",
            "telephone_number": "913-262-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "MAURICIO",
        "authorized_official_first_name": "CRISTIANA",
        "authorized_official_title_or_position": "MGR PHCY ENROLLMENTS",
        "authorized_official_telephone_number": "401-770-2937"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KS",
            "license": "2-09992",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942319413",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "1942319413",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1718507",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CarePlus CVS/pharmacy 02858",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.