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Organization
CVS PHARMACY INC
Active
Organization
CVS PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
2021 GUADALUPE ST, AUSTIN, TX 78705-5654
(512) 469-2968
Mailing address
ONE CVS DRIVE, BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
TX
333600000X
Pharmacy
Primary
—
TX
3336C0003X
Community/Retail Pharmacy
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1284731327
MEDICARE PART B
TX
05
—
471209
—
TX
01
—
5921780
NCPDP
TX
01
—
PH0708
MASS IMM
TX
Enumeration date
07/24/2017
Last updated
12/06/2017
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