Organization
LOUISIANA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY #10318
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELAITIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
9326 BURBANK DR, BATON ROUGE, LA 70820
(225) 767-0966
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
—
1937436
NCPDP
—
05
—
2202821
—
LA
Enumeration date
03/14/2014
Last updated
06/03/2015
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