Organization
LOUISIANA CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy #08958
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
5044 AMBASSADOR CAFFERY RD, LAFAYETTE, LA 70508
(337) 983-2262
Mailing address
1 CVS DR, BOX 1075- PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
6240
LA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1934961
NCPDP
—
05
—
2200097
—
LA
Enumeration date
02/22/2010
Last updated
07/10/2014
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