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NPI Code Detail

MEDICARE: LOUISIANA CVS PHARMACY, L.L.C.

MEDICARE: LOUISIANA CVS PHARMACY, L.L.C.
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
13336C0003XCommunity/Retail Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacy5840LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21901518OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1427152354
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOUISIANA CVS PHARMACY, L.L.C.
Provider Business Mailing Address
First Line : 1 CVS DR
Second Line : PO BOX 1075
City : WOONSOCKET
State : RI
Zip : 02895-6146
Country : US
Telephone Number : 401-765-1500
Fax Number :
Provider Business Practice Location Address
First Line : 6502 HIGHWAY 182 E
Second Line :
City : MORGAN CITY
State : LA
Zip : 70380-2034
Country : US
Telephone Number : 985-384-2126
Fax Number : 985-384-2120
Authorized Official
Title or Position : DIRECTOR, PAYER RELATIONS
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-770-2751
Provider Enumeration Date : 09/12/2006
Last Update Date : 11/19/2010

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