Organization
KENTUCKY CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy #06209
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(800) 746-7287
Entity
Organization
Contact information
Practice address
4101 OUTER LOOP, LOUISVILLE, KY 40219-3886
(502) 968-3618
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
P06028
KY
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1814397
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/07/2006
Last updated
05/03/2024
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