Healthcare Provider Details

I. General information

NPI: 1003913500
Provider Name (Legal Business Name): RHODE ISLAND CVS PHARMACY, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 06/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 WARWICK AVE WARWICK AVE SC
WARWICK RI
02888
US

IV. Provider business mailing address

1 CVS DR PO BOX 1075
WOONSOCKET RI
02895-6146
US

V. Phone/Fax

Practice location:
  • Phone: 401-467-7788
  • Fax:
Mailing address:
  • Phone: 401-765-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number00087
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SUSAN F COLBERT
Title or Position: DIRECTOR
Credential:
Phone: 401-765-1500