Organization
PENNSYLVANIA CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 08979
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F. COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
550 N PROGRESS AVE, HARRISBURG, PA 17109-1014
(717) 657-1149
(401) 770-7108
Mailing address
1 CVS DR, BOX 1075 PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
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
—
1015538870030
—
PA
01
—
1558698027
PACE
PA
01
—
3992876
NCPDP
PA
Enumeration date
11/04/2009
Last updated
09/27/2010
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