Organization
NEW JERSEY CVS PHARMACY LLC
Active
Other names
CVS PHARMACY 02130
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
198 NEW HAMPSHIRE AVE, LAKEWOOD, NJ 08701-3712
(732) 901-5445
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
RS005467
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3139094
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/29/2006
Last updated
11/04/2010
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