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General NPI Number Information
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NPI Number | 1033551411
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Entity Type | Organization
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Legal Business Name | CVS PHARMACY
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Dates
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Enumeration Date | 07/25/2013
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Last Update Date | 07/25/2013
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Provider Practice Location Address
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Address Line | 10730 PROVIDENCE RD
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City | CHARLOTTE
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State | NC
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Zip | 28277-2683
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Country | US
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Telephone | 704-845-2742
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Fax |
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Provider Business Mailing Address
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Address Line | 525 W 7TH ST APT 2125
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City | CHARLOTTE
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State | NC
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Zip | 28202-1443
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Country | US
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Telephone | 516-644-7979
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | SAMANTHA KRANTZ
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Credential |
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Telephone | 516-644-7979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 23599
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License Number State | NC
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