Organization
CVS PHARMACY INC.
Active
Other names
CVS Pharmacy #17124
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
6100 PASEO DEL NORTE NE, ALBUQUERQUE, NM 87113-1512
(505) 346-0136
(505) 338-3392
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
PH00004176
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2058947
PK
—
01
—
42480752
MEDICAID-DME
—
05
—
69285250
—
NM
Enumeration date
07/24/2006
Last updated
01/09/2017
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