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

General Provider Information

NPI Number	:	1215627799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CVS

Provider Business Mailing Address
First Line	:	2829 FLORIDA BLVD # 411
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-4655
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10155 OKEECHOBEE BLVD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-1404
Country	:	US
Telephone Number	:	561-784-2734
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	IVAN BABENKO
Credential	:	PHARM.D.
Telephone Number	:	609-805-0650

Provider Enumeration Date	:	05/09/2023
Last Update Date	:	05/09/2023

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Directions to “CVS ” Practice Location

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