Organization
PENNSYLVANIA CVS PHARMACY LLC
Active
Other names
CVS Pharmacy #17577
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
31 WILSON AVE, HANOVER, PA 17331-5207
(717) 634-3141
(717) 634-3151
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
PP482162
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130458
PK
—
Enumeration date
06/02/2011
Last updated
11/30/2016
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