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Organization
WISCONSIN CVS PHARMACY, L.L.C.
Active
Organization
WISCONSIN CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY # 10550
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F. COLBERT (SR. DIRECTOR-PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
2200 BRACKET AVE., EAU CLAIRE, WI 54701-4619
(715) 839-0041
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
WI
333600000X
Pharmacy
Primary
—
WI
3336C0003X
Community/Retail Pharmacy
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114310885
—
WI
01
—
5134678
NCPDP
WI
Enumeration date
03/05/2015
Last updated
01/19/2023
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