Organization
ARKANSAS CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY # 10255
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
2015 FAYETTEVILLE ROAD, VAN BUREN, AR 72956
(479) 471-1608
Mailing address
BOX 1075, ONE CVS DRIVE, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
AR
333600000X
Pharmacy
Primary
—
AR
3336C0003X
Community/Retail Pharmacy
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0424705
NCPDP
AR
05
—
205484407
—
AR
01
—
207830716
DME
AR
Enumeration date
06/30/2014
Last updated
06/29/2015
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