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General NPI Number Information
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NPI Number | 1568640522
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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 | 02/01/2008
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 1204 EASTERN AVE
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City | SCHENECTADY
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State | NY
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Zip | 12308-3502
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Country | US
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Telephone | 518-346-4063
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Fax | 518-372-2530
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Provider Business Mailing Address
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Address Line | 1204 EASTERN AVE
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City | SCHENECTADY
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State | NY
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Zip | 12308-3502
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Country | US
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Telephone | 518-346-4063
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Fax | 518-372-2530
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Authorized Official
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Title or Position | REGISTERED PHARMACIST
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Name | MS. MICHELE PALLOTTA
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Credential |
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Telephone | 518-346-4063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 031885
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License Number State | NY
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