Organization
CVS PHARMACY INC
Active
Other names
CVS Pharmacy #04880
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
805 W BUSINESS HWY 380, DECATUR, TX 76234
(940) 626-4889
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
287654201
MEDICAID DME
TX
05
—
466750
—
TX
01
—
5903516
NCPDP
—
Enumeration date
07/01/2011
Last updated
07/14/2014
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