Organization
ARIZONA CVS STORES LLC
Active
Other names
CVS PHARMACY #09319
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1179 S STATE ROUTE 260, COTTONWOOD, AZ 86326-4637
(928) 634-2147
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
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
—
0353766
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/16/2006
Last updated
07/21/2014
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