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Organization

WOODWARD DETROIT CVS, L.L.C.

Active
Other names
CVS PHARMACY #08183
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization

Contact information

Practice address
22515 GREATER MACK AVE, SAINT CLAIR SHORES, MI 48080-2040
(586) 447-4368
(586) 447-4374
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
5301-006464
MI
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2356118
OTHER ID NUMBER-COMMERCIAL NUMBER
05
3276246
MI
Enumeration date
09/05/2006
Last updated
02/22/2011
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