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NPI Code Detail

MEDICARE: NEW JERSEY CVS PHARMACY LLC

MEDICARE: NEW JERSEY 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
13336C0003XCommunity/Retail Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacyRS03459NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13125499OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548343882
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW JERSEY CVS PHARMACY LLC
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 :
Fax Number :
Provider Business Practice Location Address
First Line : 2440 HAMBURG TPKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-6226
Country : US
Telephone Number : 973-839-3400
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-765-1500
Provider Enumeration Date : 10/23/2006
Last Update Date : 06/25/2014

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