Organization
PENNSYLVANIA CVS PHARMACY LLC
Active
Other names
CVS Pharmacy # 05090
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
551 HARRISBURG AVE, LANCASTER, PA 17604-2615
(717) 391-9503
(401) 770-7108
Mailing address
1 CVS DR, 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
05
—
1015538870389
—
PA
01
—
1417240524
PACE
PA
01
—
3995517
NCPDP
PA
Enumeration date
05/23/2011
Last updated
02/22/2012
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