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NPI Code Detail

MEDICARE: ARIZONA CVS STORES LLC

MEDICARE: ARIZONA CVS STORES 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
2333600000XPharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10353831OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1851332761
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARIZONA CVS STORES 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 : 4430 E RAY RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-6092
Country : US
Telephone Number : 480-785-1006
Fax Number :
Authorized Official
Title or Position : DIRECTOR PHARMACY ENROLLMENTS
Name : SUSAN F COLBERT
Credential :
Telephone Number : 401-770-2751
Provider Enumeration Date : 06/10/2006
Last Update Date : 12/23/2014

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Directions to “ARIZONA CVS STORES LLC ” Practice Location

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