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General NPI Number Information
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NPI Number | 1023188448
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Entity Type | Organization
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Legal Business Name | NORTH CAROLINA CVS PHARMACY L.L.C.
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 9628 REA ROAD
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City | CHARLOTTE
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State | NC
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Zip | 28277
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Country | US
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Telephone | 704-542-5072
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Fax |
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Provider Business Mailing Address
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Address Line | ONE CVS DRIVE BOX 1075-PHARMACY ENROLLMENTS
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City | WOONSOCKET
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State | RI
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Zip | 02895
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Country | US
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Telephone | 401-765-1500
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Fax | 401-770-7108
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Authorized Official
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Title or Position | MANAGER PHARMACY ENROLLMENTS
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Name | CRISTIANA MAURICIO
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Credential |
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Telephone | 401-765-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 09427
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License Number State | NC
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