Organization
LOUISIANA CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 1099
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
4828 NELSON RD, LAKE CHARLES, LA 70605
(337) 477-9068
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
5724
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
691019
—
TX
Enumeration date
11/24/2006
Last updated
09/13/2017
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