Organization
PENNSYLVANIA CVS PHARMACY LLC
Active
Other names
CVS Pharmacy 07073
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR MANAGED CARE ADMINISTRATIO)
(401) 765-1500
Entity
Organization
Contact information
Practice address
290 POTTSTOWN AVE, PENNSBURG, PA 18073-1807
(215) 541-2300
(401) 770-7108
Mailing address
BOX 1075, ONE CVS DRIVE, WOONSOCKET, RI 02895
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PP481533
PA
333600000X
Pharmacy
Primary
PP481533
PA
3336C0003X
Community/Retail Pharmacy
PP481533
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015538870005
—
PA
01
—
3985516
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
09/15/2014
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