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General NPI Number Information
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NPI Number | 1396067781
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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 | 02/25/2010
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 2 WEST RD
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City | PLEASANT VALLEY
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State | NY
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Zip | 12569-7904
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Country | US
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Telephone | 845-635-1350
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Fax | 845-635-9366
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Provider Business Mailing Address
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Address Line | PO BOX 514
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City | PLEASANT VALLEY
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State | NY
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Zip | 12569-0514
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Country | US
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Telephone | 845-635-1350
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Fax | 845-635-9366
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Authorized Official
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Title or Position | PHARMACIST
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Name | BARBARA ROTH
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Credential |
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Telephone | 845-635-1350
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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 | 035776
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License Number State | NY
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