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NPI Code Detail

MEDICARE: NEW JERSEY CVS PHARMACY LLC

MEDICARE: NEW JERSEY 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
13336C0003XCommunity/Retail Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacy4152NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13129827OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932202751
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW JERSEY CVS PHARMACY 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 : 401-765-1500
Fax Number :
Provider Business Practice Location Address
First Line : 1646 MAIN AVE
Second Line :
City : CLIFTON
State : NJ
Zip : 07011-2142
Country : US
Telephone Number : 973-345-7373
Fax Number :
Authorized Official
Title or Position : DIR., MANAGED CARE ADMINISTRATION
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-770-2751
Provider Enumeration Date : 09/07/2006
Last Update Date : 11/17/2010

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Directions to “NEW JERSEY CVS PHARMACY LLC ” Practice Location

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