MEDICARE: PENNSYLVANIA CVS PHARMACY, L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00754678	OTHER		MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	3989160	OTHER	PA	COMMERCIAL NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952590481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENNSYLVANIA CVS PHARMACY, L.L.C.

Provider Business Mailing Address
First Line	:	1 CVS DR
Second Line	:	BOX 1075 - PHARMACY ENROLLMENTS
City	:	WOONSOCKET
State	:	RI
Zip	:	02895-6146
Country	:	US
Telephone Number	:	401-765-1500
Fax Number	:	401-770-7108

Provider Business Practice Location Address
First Line	:	5122 MILFORD RD.
Second Line	:
City	:	EAST STROUDSBURG
State	:	PA
Zip	:	18302
Country	:	US
Telephone Number	:	401-765-1500
Fax Number	:

Authorized Official
Title or Position	:	MANAGER, PHARMACY ENROLLMENTS
Name	:	CRISTIANA MAURICIO
Credential	:
Telephone Number	:	401-765-1500

Provider Enumeration Date	:	10/22/2007
Last Update Date	:	09/12/2014

Similar Medicare Providers

1417047531 — RITE AID OF PENNSYLVANIA LLC
Practice Location Address:

4551 MILFORD ROAD
EAST STROUDSBURG, PA
18302-8657

Practice Phone: 570-223-8062
Practice Fax:

1093892192 — DR. STANLEY MIELNICKI MD
Practice Location Address:

5221 MILFORD RD
EAST STROUDSBURG, PA
18302-9149

Practice Phone: 570-588-6197
Practice Fax:

1083791180 — DR. GEORGINE HELENE SIBBERING MD
Practice Location Address:

5221 MILFORD RD
EAST STROUDSBURG, PA
18302-9149

Practice Phone: 570-588-6197
Practice Fax:

1073687703 — SIBBERING AND MIELNICKI, ASSOC.,PC
Practice Location Address:

5221 MILFORD RD
EAST STROUDSBURG, PA
18302

Practice Phone: 570-588-6197
Practice Fax:

1609944008 — BUSHKILL EMERGENCY CORPS, INC.
Practice Location Address:

3 STERLING COURT
EAST STROUDSBURG, PA
18302

Practice Phone: 570-223-1906
Practice Fax:

1366646721 — DEBORAH REYNOLDS M.A.
Practice Location Address:

12717 DEER PATH DR
EAST STROUDSBURG, PA
18302-8643

Practice Phone: 917-604-8319
Practice Fax:

Directions to “PENNSYLVANIA CVS PHARMACY, L.L.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.