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Export Provider Record NPI 1043382302
Procare Pharmacy Direct, Llc.
Organization Subpart: NO
Active
NPI Number1043382302
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Specialty Pharmacy
Provider Details
NPI1043382302
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-11-14
Last Updated2025-12-10
Authorized OfficialBrandon Aycock
President
Phone: 4017651500
Mailing Address1 Cvs Dr, Box 1075 - Pharmacy Enrollments
Woonsocket, RI 02895-6146
United States
Phone: (401) 770-7240 | Fax: (401) 770-7108
📍 View Map
Primary Practice Address105 Mall Blvd
Monroeville, PA 15146-2230
United States
Phone: (800) 238-7828
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDPA1007692930010
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No3336C0003X – Pharmacy, Community/Retail Pharmacy
No3336H0001X – Pharmacy, Home Infusion Therapy PharmacyPAPP414230L
No332B00000X – Durable Medical Equipment & Medical Supplies
No333600000X – Pharmacy
Yes3336S0011X – Pharmacy, Specialty PharmacyPAPP-414230-L
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About NPI 1043382302

Procare Pharmacy Direct, Llc. is an organization registered in the CMS NPPES NPI Registry with NPI number 1043382302. The primary specialty listed is Pharmacy, Specialty Pharmacy. The organization is located in Monroeville, PA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-11-14. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1043382302?

NPI 1043382302 belongs to Procare Pharmacy Direct, Llc., a Pharmacy, Specialty Pharmacy in Monroeville, PA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1043382302 active?

The current status of NPI 1043382302 in the NPPES registry is Active. The record was last updated on 2025-12-10.

What specialty is NPI 1043382302?

NPI 1043382302 is classified under the taxonomy Pharmacy, Specialty Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1043382302?

You can verify NPI 1043382302 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1043382302?

The primary practice address on file for NPI 1043382302 is 105 Mall Blvd, Monroeville, PA 15146-2230. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1043382302 issued?

NPI 1043382302 was first issued (enumerated) on 2006-11-14. The NPPES record was last updated on 2025-12-10.

Practice Location Map

Procare Pharmacy Direct, Llc. is located at 105 Mall Blvd, Monroeville, PA. Use the map below to find directions or verify the practice location.

📍 105 Mall Blvd, Monroeville, PA 15146-2230  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Procare Pharmacy Direct, Llc.. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1043382302. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy, Home Infusion Therapy PharmacyPP414230LPA
Pharmacy, Specialty PharmacyPP-414230-LPA
Data Verified from CMS NPPES Last synced: 2026-06-18 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162