MEDICARE: CVS ALBANY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332BC3200X	Customized Equipment (DME)
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5813818	OTHER		NCPDP

General Provider Information

NPI Number	:	1528449378
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	:	757 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-2013
Country	:	US
Telephone Number	:	212-758-2503
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR PAYER RELATIONS
Name	:	SUSAN COLBERT
Credential	:
Telephone Number	:	401-770-2751

Provider Enumeration Date	:	06/17/2015
Last Update Date	:	02/25/2016

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Directions to “CVS ALBANY LLC ” Practice Location

Language	Start Address	Practice Location

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