Organization
PROCARE PHARMACY, LLC
Active
Other names
CVS Pharmacy #02751
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (EXEC DIR, RX SERVICES)
(401) 770-2751
Entity
Organization
Contact information
Practice address
426 S HENDERSON ST, FORT WORTH, TX 76104-1017
(866) 566-1548
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
19890
TX
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144916
—
TX
05
—
167798407
—
AR
01
—
4511057
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/29/2006
Last updated
01/11/2023
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