Organization
CVS PHARMACY INC
Active
Other names
CVS PHARMACY #17718
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
113 MAIN ST, STONEHAM, MA 02180-3305
(781) 438-1746
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
DS90091
MA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110074303X
—
MA
01
—
2245581
NCPDP
—
Enumeration date
05/03/2017
Last updated
07/21/2022
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