Organization
PENNSYLVANIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY #10767
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
4664 BROWNS HILL ROAD, PITTSBURGH, PA 15217
(412) 521-3059
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
05
—
1015538870519
—
PA
01
—
6004206
NCPDP
PA
Enumeration date
08/12/2016
Last updated
12/22/2016
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