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NPI Code Detail

MEDICARE: CVS ALBANY LLC

MEDICARE: CVS ALBANY LLC
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
13336C0003XCommunity/Retail Pharmacy
2333600000XPharmacy20917NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13398268OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1114021888
Entity Type Code : Organization
Provider Name (Legal Business Name) : CVS ALBANY LLC
Provider Business Mailing Address
First Line : 1 CVS DR
Second Line : PO BOX 1075
City : WOONSOCKET
State : RI
Zip : 02895-6146
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 753 FORT SALONGA RD
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-3148
Country : US
Telephone Number : 631-754-8374
Fax Number :
Authorized Official
Title or Position : MGR PHCY ENROLLMENTS
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-770-2937
Provider Enumeration Date : 09/12/2006
Last Update Date : 08/06/2014

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Directions to “CVS ALBANY LLC ” Practice Location

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