Organization
KENTUCKY CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 10048
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1571 N DIXIE HWY, ELIZABETHTOWN, KY 42701-2653
(270) 737-0352
Mailing address
1 CVS DR, BOX 1075 PHARMACY ENROLLMENTS, 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
01
—
1834096
NCPDP
KY
05
—
7100277390
—
KY
Enumeration date
12/06/2013
Last updated
04/11/2014
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