Organization
WOODWARD DETROIT CVS, L.L.C.
Active
Other names
CVS PHARMACY #08155
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
5529 SASHABAW RD, CLARKSTON, MI 48346-3147
(248) 620-6663
(248) 620-0236
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
5301-005979
MI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2352273
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
3011151
—
MI
Enumeration date
09/05/2006
Last updated
10/05/2011
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