Organization
KENTUCKY CVS PHARMACY, LLC
Active
Other names
CVS PHARMACY # 10049
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F. COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
803 JAMESTOWN ST., COLUMBIA, KY 42728-1009
(270) 384-0539
Mailing address
ONE CVS DRIVE, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
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
—
1833311
NCPDP
KY
05
—
7100217520
—
KY
05
—
7100238680 DME
—
KY
Enumeration date
09/10/2012
Last updated
05/29/2013
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