Organization
RHODE ISLAND CVS PHARMACY, LLC
Active
Other names
CVS Pharmacy # 05107
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1285 S COUNTY TRL, EAST GREENWICH, RI 02818-1620
(401) 886-0902
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
—
3910057 - DME
—
RI
01
—
4107430
NCPDP
RI
05
—
RI85276
—
RI
Enumeration date
04/13/2011
Last updated
11/17/2011
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