Organization
UTAH CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 10187
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
11385 S 700 E, SANDY, UT 84070-5363
(801) 572-7395
Mailing address
BOX 1075, ONE CVS DRIVE, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
UT
333600000X
Pharmacy
Primary
—
UT
3336C0003X
Community/Retail Pharmacy
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649693052
DME
UT
05
—
1649693052
—
UT
01
—
4612796
NCPDP
UT
Enumeration date
01/22/2014
Last updated
10/16/2014
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