# CVS PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS PHARMACY \#07220
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396849188
- **Authorized official:** SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 1627 WILDCAT DR, PORTLAND, TX 78374-2815
- **Practice address phone:** (361) 643-1552
- **Practice address fax:** (361) 777-0351
- **Mailing address:** 1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 24625 | TX | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/12/2006
- **Last updated:** 03/02/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000461877 | — | TX |
| 01 | — | 4559691 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |