MEDICARE: WASHINGTON CVS PHARMACY 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
1	3336C0003X	Community/Retail Pharmacy	262010403256	WA
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy

General Provider Information

NPI Number	:	1194834408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASHINGTON CVS PHARMACY LLC

Provider Business Mailing Address
First Line	:	1 CVS DR
Second Line	:
City	:	WOONSOCKET
State	:	RI
Zip	:	02895-6146
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3023 78TH AVENUE SOUTHEAST
Second Line	:	MERCER ISLAND SHOPPING CENTER
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2822
Country	:	US
Telephone Number	:	206-236-0776
Fax Number	:

Authorized Official
Title or Position	:	SR. DIRECTOR, PAYER RELATIONS
Name	:	SUSAN F COLBERT
Credential	:
Telephone Number	:	401-770-2751

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	09/19/2025

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