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General NPI Number Information
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NPI Number | 1972910388
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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 | 07/17/2014
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Last Update Date | 07/17/2014
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Provider Practice Location Address
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Address Line | 7550 S 19TH AVE # QVE
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City | PHOENIX
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State | AZ
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Zip | 85041-6502
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Country | US
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Telephone | 602-323-0583
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Fax | 602-323-2891
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Provider Business Mailing Address
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Address Line | 7550 S 19TH AVE # QVE
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City | PHOENIX
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State | AZ
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Zip | 85041-6502
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Country | US
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Telephone | 602-323-0583
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Fax | 602-323-2891
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Authorized Official
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Title or Position | PHARMACY
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Name | CVS/CAREMARK CAREMARK
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Credential |
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Telephone | 602-323-0583
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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 | S012306
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License Number State | AZ
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