Organization
NEW JERSEY CVS PHARMACY LLC
Active
Other names
CVS PHARMACY #04615
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIR., MANAGED CARE ADMINISTRATION)
(401) 770-2751
Entity
Organization
Contact information
Practice address
714 SUMMIT AVE, UNION CITY, NJ 07087-3429
(201) 866-2892
Mailing address
1 CVS DR, PO 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
5453
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0235954
—
NJ
01
—
3138991
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/07/2006
Last updated
03/07/2012
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