Organization
LOUISIANA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY #08961
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
12880 AIRLINE HWY, BATON ROUGE, LA 70817
(225) 751-3611
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
PHY006641
LA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1936597
NCPDP
—
05
—
2201867
—
LA
01
—
PHY006641RC
PHARMACY STATE LICENSE
LA
Enumeration date
11/06/2012
Last updated
03/07/2023
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