MEDICARE: CVS

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	016524	AZ

General Provider Information

NPI Number	:	1154740991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CVS

Provider Business Mailing Address
First Line	:	7434 W INDIAN SCHOOL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-3138
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7434 W INDIAN SCHOOL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-3138
Country	:	US
Telephone Number	:	623-846-5065
Fax Number	:

Authorized Official
Title or Position	:	RPH
Name	:	ARMANDO HERNANDEZ
Credential	:
Telephone Number	:	623-846-5065

Provider Enumeration Date	:	04/09/2014
Last Update Date	:	04/09/2014

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Directions to “CVS ” Practice Location

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