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NPI Code Detail

MEDICARE: MAIN STREET PHARMACY, L.L.C.

MEDICARE: MAIN STREET PHARMACY, L.L.C.
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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy
3333600000XPharmacy

General Provider Information

NPI Number : 1851974794
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAIN STREET PHARMACY, L.L.C.
Provider Business Mailing Address
First Line : 1 CVS DR # 1075
Second Line :
City : WOONSOCKET
State : RI
Zip : 02895-6146
Country : US
Telephone Number : 401-765-1500
Fax Number :
Provider Business Practice Location Address
First Line : 8000 FRANKFORD RD STE A
Second Line :
City : DALLAS
State : TX
Zip : 75252-6894
Country : US
Telephone Number : 214-459-8873
Fax Number :
Authorized Official
Title or Position : SR DIRECTOR
Name : SUSAN F COLBERT
Credential :
Telephone Number : 401-770-2751
Provider Enumeration Date : 04/29/2021
Last Update Date : 07/30/2021

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Directions to “MAIN STREET PHARMACY, L.L.C. ” Practice Location

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