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General NPI Number Information
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NPI Number | 1184030462
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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 | 07/07/2014
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 3310 SISKEY PKWY
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City | MATTHEWS
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State | NC
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Zip | 28105-3222
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Country | US
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Telephone | 704-849-2271
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Fax |
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Provider Business Mailing Address
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Address Line | 1509 MAINLINE BLVD APT 6202
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City | CHARLOTTE
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State | NC
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Zip | 28203-0518
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Country | US
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Telephone | 717-315-6103
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | VANTONILE VIEN BUI
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Credential | PHARMD
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Telephone | 717-315-6103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 24211
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License Number State | NC
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