Organization
RHODE ISLAND CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy #00409
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1123 BOSTON NECK RD, NARRAGANSETT, RI 02882-1734
(401) 783-1753
(401) 770-7108
Mailing address
1 CVS DR, BOX 1075-PROVIDER ENROLLMENTS, 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
01
—
4106995
NCPDP
—
01
—
P00814005
MEDICARE RR
—
05
—
RI68904
—
RI
Enumeration date
10/02/2007
Last updated
10/25/2021
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