Organization
WOODWARD DETROIT CVS, L.L.C.
Active
Other names
CVS PHARMACY #08103
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
33 WEST NINE MILE RD., HAZEL PARK, MI 48030-1413
(248) 541-1650
(248) 414-5753
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
5301-005452
MI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2347486
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
2683275
—
MI
Enumeration date
08/31/2006
Last updated
06/26/2014
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