Organization
CVS PHARMACY INC
Active
Other names
CVS Pharmacy #10055
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1901 RICHMOND RD, TEXARKANA, TX 75503-2424
(903) 255-0316
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
01
—
156809407
AR MEDICAID
AR
01
—
196795716
AR MEDICAID DME
AR
05
—
466872
—
TX
01
—
5907451
NCPDP
—
Enumeration date
11/06/2012
Last updated
06/10/2014
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