Organization
LOUISIANA CVS PHARMACY LLC
Active
Other names
CVS Pharmacy #16801
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
4103 PECANLAND MALL DR, MONROE, LA 71203-7009
(318) 388-3474
(318) 388-3474
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
PHY.007241-RC
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2035078
PK
—
Enumeration date
07/24/2006
Last updated
10/05/2016
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