Healthcare Provider Details

I. General information

NPI: 1942305784
Provider Name (Legal Business Name): GERMAN DOBSON CVS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 W BASELINE RD
LAVEEN AZ
85339-7324
US

IV. Provider business mailing address

1 CVS DR BOX 1075
WOONSOCKET RI
02895-6146
US

V. Phone/Fax

Practice location:
  • Phone: 602-237-8681
  • Fax: 401-735-1080
Mailing address:
  • Phone: 401-765-1500
  • Fax: 401-735-1080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number4436
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: SUSAN F COLBERT
Title or Position: SR DIRECTOR, PAYER RELATIONS
Credential:
Phone: 800-746-7287