Organization
CVS PHARMACY, INC
Active
Other names
CVS Pharmacy # 05872
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
22135 IH-10 W, SAN ANTONIO, TX 78257-1621
(210) 698-1643
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
TX
333600000X
Pharmacy
Primary
—
TX
3336C0003X
Community/Retail Pharmacy
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
282651301
MEDICAID DME
TX
05
—
466736
—
TX
01
—
5902451
NCPDP
TX
Enumeration date
02/07/2011
Last updated
03/16/2012
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