Organization
NEW JERSEY CVS PHARMACY LLC
Active
Other names
CVS PHARMACY 00478
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
9015 BERGENLINE AVE AND 90TH ST, NORTH BERGEN, NJ 07047
(201) 869-3930
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
RS03066
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3123089
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/24/2006
Last updated
03/07/2012
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