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General NPI Number Information
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NPI Number | 1922453026
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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 | 04/26/2016
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 30261 GOLDEN LANTERN
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-5979
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Country | US
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Telephone | 949-363-0482
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Fax |
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Provider Business Mailing Address
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Address Line | 31011 VIA ESTENAGA
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-2931
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Country | US
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Telephone | 949-443-0363
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. KAREN Z KASSABIAN
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Credential |
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Telephone | 949-443-0363
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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 | 58322
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License Number State | CA
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