Organization
CVS PHARMACY INC
Active
Other names
CVS PHARMACY #10448
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
801 N CANAL ST, CARLSBAD, NM 88220-5107
(575) 941-0250
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27632067
MEDICAID (DME)
NM
01
—
3213268
NCPDP
—
05
—
55927777
—
NM
Enumeration date
08/09/2016
Last updated
03/16/2017
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