MEDICARE: UTAH CVS PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy

General Provider Information

NPI Number	:	1467381962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UTAH CVS PHARMACY LLC

Provider Business Mailing Address
First Line	:	1 CVS DR
Second Line	:	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	:	1350 N MAIN ST
Second Line	:
City	:	NORTH LOGAN
State	:	UT
Zip	:	84341
Country	:	US
Telephone Number	:	401-765-1500
Fax Number	:

Authorized Official
Title or Position	:	SR DIRECTOR
Name	:	SUSAN F COLBERT
Credential	:
Telephone Number	:	401-765-1500

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/29/2026

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Directions to “UTAH CVS PHARMACY LLC ” Practice Location

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