Organization
WISCONSIN CVS PHARMACY, L.L.C
Active
Other names
CVS PHARMACY # 01267
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
7550 W PERKINS PL, MILWAUKEE, WI 53216-1024
(414) 466-4875
Mailing address
1 CVS DR, BOS 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
05
—
36225000
—
WI
01
—
5130339
NCPDP
—
Enumeration date
11/28/2007
Last updated
03/05/2014
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