Organization
LOUISIANA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 00167
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
4401 S CLAIBORNE AVE, NEW ORLEANS, LA 70125-5105
(504) 891-7731
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
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
—
1935709
NCPDP
—
05
—
2201425
—
LA
01
—
PHY006509RC
PHARMACY STATE LICENSE
—
Enumeration date
06/06/2011
Last updated
03/07/2023
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