Organization
PENNSYLVANIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 10250
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1198 SCALP AVE, JOHNSTOWN, PA 15904-3053
(814) 266-1454
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
01
—
6002098
NCPDP
—
Enumeration date
04/20/2015
Last updated
08/31/2015
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