Organization
UTAH CVS PHARMACY LLC
Active
Other names
CVS PHARMACY# 10332
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
3148 W 3500 S, WEST VALLEY CITY, UT 84119
(801) 963-2389
(801) 963-2377
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
01
—
1801209028
DME
UT
05
—
1801209028
—
UT
01
—
4612974
NCPDP
UT
Enumeration date
06/05/2014
Last updated
06/18/2015
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