Organization
CVS PHARMACY INC
Active
Other names
CVS PHARMACY # 06775
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, MANAGED CARE ADMIN)
(401) 770-2751
Entity
Organization
Contact information
Practice address
701 E MAIN ST, GRAND PRAIRIE, TX 75050-5867
(972) 264-2371
(972) 642-4801
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
TX
333600000X
Pharmacy
Primary
24651
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207438701
DME
TX
01
—
4507072
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
460434
—
TX
Enumeration date
09/12/2006
Last updated
02/25/2015
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