Organization
CVS PHARMACY INC
Active
Other names
CVS Pharmacy# 05407
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
11 MAIN STREET, LAKEVILLE, MA 02347-1617
(508) 946-8690
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
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110088108C
—
MA
01
—
2243525
NCPDP
—
Enumeration date
04/01/2011
Last updated
11/03/2011
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