Organization
RHODE ISLAND CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 00247
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
444 WILLETT AVE, RIVERSIDE, RI 02915-2515
(401) 433-1120
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
—
RI
333600000X
Pharmacy
Primary
PHA00459
RI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110066367A
—
MA
01
—
3910038
DME
RI
01
—
4102466
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
RI 75151
—
RI
Enumeration date
09/12/2006
Last updated
07/12/2011
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