Organization
PENNSYLVANIA CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 05533
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
6050 STERNER'S WAY, BETHLEHEM, PA 18017
(610) 837-4220
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
05
—
1015538870023
—
PA
01
—
1689821365
PACE
PA
01
—
3990985
NCPDP
PA
Enumeration date
08/25/2008
Last updated
09/15/2014
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