MEDICARE: CVS PHARMACY INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy

General Provider Information

NPI Number	:	1396303715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CVS PHARMACY INC

Provider Business Mailing Address
First Line	:	1 CVS DR
Second Line	:	BOX 1075
City	:	WOONSOCKET
State	:	RI
Zip	:	02895
Country	:	US
Telephone Number	:	401-765-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 DILLON DR
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81008-1040
Country	:	US
Telephone Number	:	719-696-6685
Fax Number	:

Authorized Official
Title or Position	:	SR. DIRECTOR, PAYER RELATIONS
Name	:	SUSAN F COLBERT
Credential	:
Telephone Number	:	401-770-2751

Provider Enumeration Date	:	05/31/2019
Last Update Date	:	10/10/2019

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Directions to “CVS PHARMACY INC ” Practice Location

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