Organization
PENNSYLVANIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY 10249
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1650 MENOHER BLVD, JOHNSTOWN, PA 15905-2000
(814) 255-2792
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467835546 PACE
—
PA
01
—
6002478
NCPDP
PA
Enumeration date
07/07/2015
Last updated
11/04/2015
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