Organization
GERMAN DOBSON CVS LLC
Active
Other names
CVS Pharmacy #02412
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
60 E DEUCE OF CLUBS, SHOW LOW, AZ 85901-4814
(928) 532-3200
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 735-1080
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
—
0357081
NCPDP
—
05
—
622607
—
AZ
01
—
P00959043
RR PTAN
—
Enumeration date
04/18/2011
Last updated
03/27/2024
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