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Organization
CVS PHARMACY INC
Active
Organization
CVS PHARMACY INC
Active
Other names
CVS PHARMACY #10909
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTORE)
(401) 765-1500
Entity
Organization
Contact information
Practice address
6474 E. NORTHWEST HWY, DALLAS, TX 75214
(469) 232-4590
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1284731316
MEDICARE B
TX
05
—
471186
—
TX
01
—
5921083
NCPDP
TX
01
—
PH0708
MASS IMM
TX
Enumeration date
04/04/2017
Last updated
07/21/2022
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