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General NPI Number Information
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NPI Number | 1225468457
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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 | 11/25/2013
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Last Update Date | 11/25/2013
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Provider Practice Location Address
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Address Line | 10012 WEISS WAY
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City | WAXHAW
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State | NC
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Zip | 28173-0800
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Country | US
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Telephone | 704-321-0241
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Fax |
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Provider Business Mailing Address
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Address Line | 10012 WEISS WAY
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City | WAXHAW
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State | NC
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Zip | 28173-0800
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MRS. ARGELIA V GOODNER
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Credential | PHARM.D
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Telephone | 704-321-0241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 23592
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License Number State | NC
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