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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15810381OTHERNCPDP

General Provider Information

NPI Number : 1396165155
Entity Type Code : Organization
Provider Name (Legal Business Name) : CVS ALBANY 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 : 10811 QUEENS BLVD
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4840
Country : US
Telephone Number : 718-544-4585
Fax Number :
Authorized Official
Title or Position : SR. DIRECTOR, PAYER RELATIONS
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-770-2751
Provider Enumeration Date : 04/21/2014
Last Update Date : 06/03/2015

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Directions to “CVS ALBANY LLC ” Practice Location

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