Organization
ARIZONA CVS STORES LLC
Active
Other names
CVS PHARMACY #08952
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
24865 N LAKE PLEASANT PARKWAY, PEORIA, AZ 85383-1280
(623) 566-1110
Mailing address
1 CVS DR, BOX 1075 PHARMACY ENROLLMENTS, 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
—
0358778
NCPDP
—
05
—
926857
—
AZ
Enumeration date
04/17/2014
Last updated
09/08/2014
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