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NPI Code Detail

MEDICARE: CVS PHARMACY INC

MEDICARE: CVS PHARMACY INC
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
3333600000XPharmacy24705TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24571990OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1760586564
Entity Type Code : Organization
Provider Name (Legal Business Name) : CVS PHARMACY INC
Provider Business Mailing Address
First Line : 1 CVS DR
Second Line : PO 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 : 460 NORTHWEST PKWY
Second Line :
City : AZLE
State : TX
Zip : 76020-3136
Country : US
Telephone Number : 817-444-7099
Fax Number : 817-444-5587
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 : 03/03/2015

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