Organization
PENNSYLVANIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 10288
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
717 E MAIN ST, PALMYRA, PA 17078-1911
(717) 838-8242
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
—
1015538870432
—
PA
01
—
1558771048
PACE
PA
01
—
6000498
NCPDP
PA
Enumeration date
05/06/2014
Last updated
11/13/2014
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