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Organization

NEBRASKA CVS PHARMACY LLC

Active
Other names
CVS PHARMACY #05714
Organization subpart
No

Provider details

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

Contact information

Practice address
4840 DODGE ST, OMAHA, NE 68132
(402) 558-2000
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146

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
10026093900
NE
01
2818221
NCPDP
Enumeration date
08/17/2011
Last updated
03/06/2012
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