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Organization

PROCARE PHARMACY LLC

Active
Other names
CVS PHARMACY #02801
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization

Contact information

Practice address
8607 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90069-4109
(800) 300-1199
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
PHY49047
3336C0003X
Community/Retail Pharmacy
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0558796
OTHER ID NUMBER-COMMERCIAL NUMBER
05
1407965973
CA
Enumeration date
08/29/2006
Last updated
09/01/2021
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