MEDICARE: ALABAMA 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
1	332B00000X	Durable Medical Equipment & Medical Supplies		AL
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy	112782	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00754161	OTHER		MEDICARE RR

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
3	1558466383	OTHER	AL	DME
4	0133621	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1558466383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALABAMA 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	:	401-735-1080

Provider Business Practice Location Address
First Line	:	4736 EASTERN VALLEY RD
Second Line	:
City	:	MC CALLA
State	:	AL
Zip	:	35111-3406
Country	:	US
Telephone Number	:	205-477-8049
Fax Number	:

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	03/26/2024

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Directions to “ALABAMA CVS PHARMACY LLC ” Practice Location

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