Healthcare Provider Details
I. General information
NPI: 1588767214
Provider Name (Legal Business Name): ALABAMA CVS PHARMACY, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2006
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1535 DECATUR HWY
FULTONDALE AL
35068-1733
US
IV. Provider business mailing address
1 CVS DR BOX 1075
WOONSOCKET RI
02895-6146
US
V. Phone/Fax
- Phone: 205-849-9744
- Fax:
- Phone: 401-765-1500
- Fax: 401-735-1080
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | 110869 |
| License Number State | AL |
VIII. Authorized Official
Name:
SUSAN
F
COLBERT
Title or Position: SR. DIRECTOR, PAYER RELATIONS
Credential:
Phone: 401-770-2751