Organization
IOWA CVS PHARMACY, LLC
Active
Other names
CVS Pharmacy # 04816
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
545 W. WASHINGTON ST, COUNCIL BLUFFS, IA 51503-0771
(712) 352-4152
Mailing address
1 CVS DR, BOX - 1075 PHCY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
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
—
1194020602
—
IA
01
—
1623986
NCPDP
IA
Enumeration date
01/13/2011
Last updated
03/06/2012
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