Organization
CVS PHARMACY INC
Active
Other names
CVS Pharmacy # 08906
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
575 BROADWAY, MALDEN, MA 02148-2039
(781) 321-1017
Mailing address
1 CVS DR, BOX 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
—
110087561W
—
MA
01
—
2243335
NCPDP
—
Enumeration date
08/27/2009
Last updated
03/13/2012
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