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Organization
CVS PHARMACY INC
Active
Organization
CVS PHARMACY INC
Active
Other names
CVS PHARMACY 07631
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2603 W BERRY ST, FORT WORTH, TX 76109-1770
(817) 923-8259
(817) 923-9486
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
TX
333600000X
Pharmacy
Primary
24520
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000463132
—
TX
01
—
207271201
DME
TX
01
—
4580747
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
03/06/2015
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