Organization
WOODWARD DETROIT CVS, L.L.C.
Active
Other names
CVS Pharmacy # 05610
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F. COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
3590 PLAINFIELD AVE NE, GRAND RAPIDS, MI 49525-2719
(616) 447-2563
(401) 770-7108
Mailing address
1 CVS DR, 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
—
1861796112 RX
—
MI
01
—
2374837
NCPDP
MI
Enumeration date
12/30/2010
Last updated
05/09/2011
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