Organization
CVS PHARMACY INC
Active
Other names
CVS PHARMACY #07441
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTIANA MAURICIO (MGR PHCY ENROLLMENTS)
(401) 770-2937
Entity
Organization
Contact information
Practice address
2005 HIGHWAY 90, LIBERTY, TX 77575-5817
(936) 336-7233
(936) 334-0239
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
24739
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000462043
—
TX
01
—
4563765
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
P00754740
MEDICARE RR
TX
Enumeration date
09/12/2006
Last updated
03/03/2015
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