# RHODE ISLAND CVS PHARMACY, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS Pharmacy \# 04096
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720236821
- **Authorized official:** CRISTIANA MAURICIO (MGR PHCY ENROLLMENTS)
- **Authorized official phone:** (401) 765-1500

## Contact information

- **Practice address:** 309 BROAD ST., CENTRAL FALLS, RI 02863
- **Practice address phone:** (401) 721-9880
- **Mailing address:** 1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500
- **Mailing address fax:** (407) 770-7108

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/03/2008
- **Last updated:** 06/16/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4107125 | NCPDP | RI |
| 01 | — | 6013910 | DME | RI |
| 05 | — | RI 73082 | — | RI |