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NPI Code Detail

MEDICARE: NORTH CAROLINA CVS PHARMACY LLC

MEDICARE: NORTH CAROLINA 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
3333600000XPharmacy6634NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13424114OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942303631
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH CAROLINA CVS PHARMACY LLC
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 : 605 N MAIN ST
Second Line :
City : FUQUAY VARINA
State : NC
Zip : 27526-2026
Country : US
Telephone Number : 919-552-8299
Fax Number :
Authorized Official
Title or Position : DIRECTOR, PAYER RELATIONS
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-770-2751
Provider Enumeration Date : 09/07/2006
Last Update Date : 10/07/2011

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Directions to “NORTH CAROLINA CVS PHARMACY LLC ” Practice Location

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