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NPI Code Detail

MEDICARE: CVS

MEDICARE: CVS
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 PharmacyPS54875FL

General Provider Information

NPI Number : 1801246251
Entity Type Code : Organization
Provider Name (Legal Business Name) : CVS
Provider Business Mailing Address
First Line : 13740 BEACH BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-6033
Country : US
Telephone Number : 904-248-4364
Fax Number :
Provider Business Practice Location Address
First Line : 13740 BEACH BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-6033
Country : US
Telephone Number : 904-248-4364
Fax Number :
Authorized Official
Title or Position : PHARMACIST
Name : MARY ALICE ANDERSON
Credential : PHARMD
Telephone Number : 904-412-6410
Provider Enumeration Date : 06/16/2016
Last Update Date : 06/16/2016

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1689968869 — LORI INDRIOLO PHARMD
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1265878862 — MS. KARIN E JONES RPH
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Directions to “CVS ” Practice Location

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