MEDICARE: CVS PHARMACY

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
1	261QC1800X	Corporate Health Clinic/Center	5	CA

General Provider Information

NPI Number	:	1396118162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CVS PHARMACY

Provider Business Mailing Address
First Line	:	11574 LOWER AZUSA RD
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732-1333
Country	:	US
Telephone Number	:	626-350-3550
Fax Number	:	626-350-3557

Provider Business Practice Location Address
First Line	:	11574 LOWER AZUSA RD
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732-1333
Country	:	US
Telephone Number	:	626-350-3550
Fax Number	:	626-350-3557

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MS. SHIRLEY VIENVUONG
Credential	:	PHARM. D
Telephone Number	:	626-350-3550

Provider Enumeration Date	:	11/03/2015
Last Update Date	:	07/21/2022

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Directions to “CVS PHARMACY ” Practice Location

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