Organization
CARECENTER PHARMACY LLC
Active
Other names
CVS Pharmacy # 02477
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
208 S AKARD ST # PC08, DALLAS, TX 75202-4206
(214) 741-4912
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
—
TX
333600000X
Pharmacy
Primary
—
TX
3336C0003X
Community/Retail Pharmacy
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
217577001
DME
TX
01
—
4553447
NCPDP
TX
05
—
466698
—
TX
Enumeration date
08/06/2009
Last updated
07/21/2022
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