Organization
KANSAS CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY # 05268
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
390 LIMIT ST, LEAVENWORTH, KS 66048-4525
(913) 651-2323
(913) 680-1294
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
2-09937
KS
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1712858
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
200384100X
—
KS
Enumeration date
09/12/2006
Last updated
09/30/2014
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