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NPI Code Detail

MEDICARE: CVS ALBANY, L.L.C

MEDICARE: CVS ALBANY, L.L.C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy
3333600000XPharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15819757OTHERNCPDP

General Provider Information

NPI Number : 1134658180
Entity Type Code : Organization
Provider Name (Legal Business Name) : CVS ALBANY, L.L.C
Provider Business Mailing Address
First Line : 1 CVS DR
Second Line :
City : WOONSOCKET
State : RI
Zip : 02895-6146
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 150 50TH AVE
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-6050
Country : US
Telephone Number : 401-765-1500
Fax Number :
Authorized Official
Title or Position : SR DIRECTOR PAYER RELATIONS
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-765-1500
Provider Enumeration Date : 06/05/2017
Last Update Date : 07/05/2017

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