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NPI Code Detail

MEDICARE: UTAH CVS PHARMACY LLC

MEDICARE: UTAH CVS PHARMACY LLC
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 Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacy

General Provider Information

NPI Number : 1689182693
Entity Type Code : Organization
Provider Name (Legal Business Name) : UTAH CVS PHARMACY LLC
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 : 1269 E 2100 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84106-2824
Country : US
Telephone Number : 401-765-1500
Fax Number :
Authorized Official
Title or Position : SR DIRECTOR PAYER RELATIONS
Name : SUSAN F COLBERT
Credential :
Telephone Number : 401-770-2751
Provider Enumeration Date : 01/12/2018
Last Update Date : 01/12/2018

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Directions to “UTAH CVS PHARMACY LLC ” Practice Location

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