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NPI Code Detail

MEDICARE: NEBRASKA CVS PHARMACY LLC

MEDICARE: NEBRASKA 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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy
3333600000XPharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12817976OTHERNCPDP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306167168
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEBRASKA CVS PHARMACY LLC
Provider Business Mailing Address
First Line : 1 CVS DR
Second Line : BOX 1075 PHARMACY ENROLLMENTS
City : WOONSOCKET
State : RI
Zip : 02895-6146
Country : US
Telephone Number : 401-765-1500
Fax Number :
Provider Business Practice Location Address
First Line : 14460 W MAPLE RD
Second Line :
City : OMAHA
State : NE
Zip : 68116-5163
Country : US
Telephone Number : 402-493-0443
Fax Number :
Authorized Official
Title or Position : DIRECTOR PAYER RELATIONS
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-765-1500
Provider Enumeration Date : 06/16/2010
Last Update Date : 03/13/2012

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Directions to “NEBRASKA CVS PHARMACY LLC ” Practice Location

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