Organization
PENNSYLVANIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 10526
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR)
(401) 770-2751
Entity
Organization
Contact information
Practice address
259 MARKET ST, PHILADELPHIA, PA 19106-4502
(215) 625-3740
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
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
—
1015538870443
—
PA
01
—
114393063
PACE
PA
01
—
6002670
NCPDP
PA
Enumeration date
08/14/2015
Last updated
12/21/2015
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