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General NPI Number Information
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NPI Number | 1881004505
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Entity Type | Organization
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Legal Business Name | CVS/CAREMARK
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Dates
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Enumeration Date | 05/02/2014
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Last Update Date | 05/02/2014
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Provider Practice Location Address
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Address Line | 15100 N 90TH ST SUITE 110
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-2901
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Country | US
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Telephone | 480-882-8038
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Fax | 701-733-0096
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Provider Business Mailing Address
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Address Line | 6035 N 17TH ST
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City | PHOENIX
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State | AZ
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Zip | 85016-1807
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Country | US
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Telephone | 480-584-9188
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Fax | 401-733-0096
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Authorized Official
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Title or Position | PHARMD
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Name | AMBER LEIGH WILKINS
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Credential |
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Telephone | 480-584-9188
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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 | S016214
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License Number State | AZ
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