Organization
CVS PHARMACY INC
Active
Other names
CVS Pharmacy # 05990
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
904 E CARTWRIGHT RD, MESQUITE, TX 75149-6623
(972) 888-3404
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
TX
333600000X
Pharmacy
Primary
—
TX
3336C0003X
Community/Retail Pharmacy
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
281427901
MEDICAID DME
TX
05
—
466721
—
TX
01
—
5901841
NCPDP
TX
Enumeration date
11/24/2010
Last updated
10/25/2011
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