Healthcare Provider Details

I. General information

NPI: 1063610475
Provider Name (Legal Business Name): GERMAN DOBSON CVS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THOMAS & 43RD AVE
PHOENIX AZ
85019
US

IV. Provider business mailing address

ONE CVS DRIVE BOX 1075-PHARMACY ENROLLMENTS
WOONSOCKET RI
02895
US

V. Phone/Fax

Practice location:
  • Phone: 401-765-1500
  • Fax:
Mailing address:
  • Phone: 401-765-1500
  • Fax: 401-770-7108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. THOMAS RYAN
Title or Position: CHAIRMAN, PRESIDENT AND CEO
Credential:
Phone: 401-765-1500