Organization
PENNSYLVANIA CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 05867
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
401 SPRING GARDEN ST, PHILADELPHIA, PA 19123-2818
(215) 418-3065
(401) 770-7108
Mailing address
1 CVS DR, 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
—
1015538870034
—
PA
01
—
1619299690
PACE
PA
01
—
3993347
NCPDP
PA
Enumeration date
02/18/2010
Last updated
09/23/2010
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