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NPI Code Detail

MEDICARE: CVS PHARMACY INC.

MEDICARE: CVS PHARMACY INC.
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
13336C0003XCommunity/Retail PharmacyPDO.0000000736CO
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11997843OTHERPK

General Provider Information

NPI Number : 1457512576
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 : 02895-6146
Country : US
Telephone Number : 401-765-1500
Fax Number :
Provider Business Practice Location Address
First Line : 2936 COUNCIL TREE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-6300
Country : US
Telephone Number : 970-530-3121
Fax Number : 970-530-3131
Authorized Official
Title or Position : SR. DIRECTOR, PAYER RELATIONS
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-770-2751
Provider Enumeration Date : 06/20/2008
Last Update Date : 10/17/2016

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