Organization
MISSISSIPPI CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY #05825
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
820 HIGHWAY 19 N STE 195, MERIDIAN, MS 39307-5820
(601) 482-7194
(601) 483-7056
Mailing address
1 CVS DR, PO 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
00659/01.2
MS
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000330343
—
MS
01
—
2500317
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/22/2006
Last updated
01/17/2023
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