Organization
CONNECTICUT CVS PHARMACY LLC
Active
Other names
CVS Pharmacy #10605
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
37 W MAIN ST, STAFFORD SPRINGS, CT 06076-1459
(860) 684-0015
Mailing address
1 CVS DR, BOX 1075, 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
05
—
008057531
—
CT
01
—
008059320
MEDICAID DME
CT
01
—
0723672
NCPDP
—
Enumeration date
11/24/2014
Last updated
07/29/2015
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