Organization
PENNSYLVANIA CVS PHARMACY LLC
Active
Other names
CVS Pharmacy # 00342
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
3016 ROUTE 940, POCONO SUMMIT, PA 18344-2310
(570) 839-6670
Mailing address
1 CVS DR, P.O. BOX 1075- PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015538870391
—
PA
01
—
3995707
NCPDP
PA
Enumeration date
07/13/2011
Last updated
07/30/2012
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