Organization
PROCARE PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY #02733
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1601 17TH ST NW, WASHINGTON, DC 20009-2403
(866) 813-3603
Mailing address
1 CVS DR, PO 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
RX-00-00294
DC
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027104400
—
DC
01
—
0903814
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
1225147796
MD MED DME #
MD
05
—
1225147796
—
MD
Enumeration date
08/29/2006
Last updated
01/31/2021
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