Organization
UTAH CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 10578
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR-PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
11506 S 4000 W, SOUTH JORDAN, UT 84009-6070
(801) 446-9995
Mailing address
ONE CVS DRIVE, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
UT
333600000X
Pharmacy
Primary
—
UT
3336C0003X
Community/Retail Pharmacy
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235517053
—
UT
01
—
4613217
NCPDP
UT
Enumeration date
05/13/2015
Last updated
01/05/2022
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