Organization
WISCONSIN CVS PHARMACY LLC
Active
Other names
CVS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
240 E HAMPTON RD, WHITEFISH BAY, WI 53217-5850
(414) 962-7071
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5128966
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/14/2006
Last updated
09/14/2012
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