Organization
CVS PHARMACY INC
Active
Other names
CVS PHARMACY #07680
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTIANA MAURICIO (MGR PHCY ENROLLMENTS)
(401) 770-2937
Entity
Organization
Contact information
Practice address
1870 W MOORE AVE, TERRELL, TX 75160-2309
(972) 563-7636
(972) 563-0946
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
TX
333600000X
Pharmacy
Primary
24918
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000463106
—
TX
01
—
207425401
DME
TX
01
—
4581004
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
P00754740
MEDICARE RR
TX
Enumeration date
09/12/2006
Last updated
03/09/2015
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