Organization
CVS PHARMACY INC
Active
Other names
CVS PHARMACY #10449
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
610 SILVER HEIGHTS BLVD, SILVER CITY, NM 88061-6942
(575) 388-1614
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
—
18376321
—
NM
01
—
3212735
NCPDP
—
01
—
58687238
MEDICAID (DME)
NM
Enumeration date
08/06/2014
Last updated
04/17/2015
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