# WISCONSIN CVS PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Target Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538463492
- **Authorized official:** SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 750 HILLDALE WAY, MADISON, WI 53705-2644
- **Practice address phone:** (608) 807-3979
- **Practice address fax:** (608) 807-3989
- **Mailing address:** 1 CVS DR, MAIL CODE 1090, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9060-42 | WI | Yes |

## Other

- **Enumeration date:** 01/06/2011
- **Last updated:** 01/11/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1538463492 | — | WI |
| 01 | — | 2128274 | PK | — |