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Organization

PENNSYLVANIA CVS PHARMACY LLC

Active
Other names
CVS Pharmacy # 05081
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization

Contact information

Practice address
101 W CITY AVE, BALA CYNWYD, PA 19004-3164
(610) 668-3890
Mailing address
1 CVS DR, P. O. BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108

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
1015538870397
PA
01
1811276777
PACE
PA
01
3995810
NCPDP
PA
Enumeration date
08/10/2011
Last updated
02/22/2012
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