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General NPI Number Information
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NPI Number | 1366838328
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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 | 04/07/2015
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Last Update Date | 04/07/2015
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Provider Practice Location Address
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Address Line | 1223 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10065-7402
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Country | US
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Telephone | 212-752-7703
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Fax | 212-752-9683
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Provider Business Mailing Address
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Address Line | 1223 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10065-7402
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Country | US
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Telephone | 212-752-7703
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Fax | 212-752-9683
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. MATTHEW LIN
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Credential | PHARMD
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Telephone | 212-752-7703
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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 | 059810
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License Number State | NY
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