Organization
WISCONSIN CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 08764
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
2135 SILVERNAIL RD, PEWAUKEE, WI 53072-5525
(262) 513-9221
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5129110
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/12/2006
Last updated
03/07/2014
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