Organization
PROCARE PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 02553
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1117 WALNUT ST, PHILADELPHIA, PA 19107-4918
(866) 813-3899
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
PP410995L
PA
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3976656
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/29/2006
Last updated
09/01/2021
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