Organization
LOUISIANA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY# 10058
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1116 LOUISIANA AVE, NEW ORLEANS, LA 70115-2454
(504) 891-1818
Mailing address
1 CVS DR, BOX 1075 PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
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
—
1938919
NCPDP
—
05
—
2204025
—
LA
Enumeration date
09/21/2015
Last updated
12/11/2015
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