Organization
WASHINGTON CVS PHARMACY LLC
Active
Other names
CVS Pharmacy #10659
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
33520 21ST AVE SW, FEDERAL WAY, WA 98023-2874
(253) 838-1611
Mailing address
1 CVS DR, BOX 1075 -PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(491) 765-1500
(401) 770-7108
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
—
2076635
—
WA
01
—
4938075
NCPDP
—
Enumeration date
11/16/2016
Last updated
05/12/2017
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