Organization
CVS PHARMACY, INC.
Active
Other names
CVS Pharmacy # 05465
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1421 SW WILSHIRE BLVD, BURLESON, TX 76028-5705
(817) 295-8659
Mailing address
1 CVS DR, BOX 1075 - PHARMACY 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
01
—
216761101
DME
TX
01
—
4553067
NCPDP
TX
05
—
466706
—
TX
Enumeration date
07/21/2009
Last updated
03/16/2012
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