MEDICARE: CVS PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	74633	HI
2	3336C0003X	Community/Retail Pharmacy	74633	CA

General Provider Information

NPI Number	:	1063947570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CVS PHARMACY

Provider Business Mailing Address
First Line	:	2609 IVY DR
Second Line	:	APT 16
City	:	OAKLAND
State	:	CA
Zip	:	94606-2192
Country	:	US
Telephone Number	:	808-256-8510
Fax Number	:

Provider Business Practice Location Address
First Line	:	2609 IVY DR
Second Line	:	APT 16
City	:	OAKLAND
State	:	CA
Zip	:	94606-2192
Country	:	US
Telephone Number	:	808-256-8510
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	EDWINA YIN CHING LEUNG
Credential	:	PHARMD
Telephone Number	:	808-256-8510

Provider Enumeration Date	:	04/23/2017
Last Update Date	:	04/23/2017

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Directions to “CVS PHARMACY ” Practice Location

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