Organization
WISCONSIN CVS PHARMACY LLC
Active
Other names
CVS PHARMACY# 03394
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
3860 S 27TH ST, MILWAUKEE, WI 53221-1307
(414) 282-7557
Mailing address
1 CVS DR, BOX 1075, 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
—
36228100
—
WI
01
—
5130757
NCPDP
—
Enumeration date
06/06/2008
Last updated
03/07/2014
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