Organization
LOUISIANA CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 266
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
2000 RYAN ST, LAKE CHARLES, LA 70601
(337) 439-4241
Mailing address
ONE CVS DRIVE, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5701
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1222101
—
LA
01
—
1932979
NCPDP
LA
01
—
5766170001
MEDICARE B
LA
05
—
691015
—
TX
Enumeration date
10/02/2006
Last updated
09/13/2017
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