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General NPI Number Information
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NPI Number | 1154736064
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Entity Type | Organization
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Legal Business Name | CVS
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Dates
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Enumeration Date | 06/30/2014
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Last Update Date | 06/30/2014
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Provider Practice Location Address
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Address Line | 7004 YOUREE DRIVE
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City | SHREVEPORT
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State | LA
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Zip | 71005
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Country | US
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Telephone | 318-797-3665
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Fax |
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Provider Business Mailing Address
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Address Line | 7005 YOUREE DRIVE
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City | SHREVEPORT
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State | LA
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Zip | 71005
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Country | US
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Telephone | 318-797-3665
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Fax |
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Authorized Official
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Title or Position | PHARMACIST-IN-CHARGE
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Name | MRS. ANGELA WALDRON ALLUMS
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Credential | RPH
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Telephone | 318-553-2726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | CDS.039623
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License Number State | LA
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