Organization
NEW JERSEY CVS PHARMACY LLC
Active
Other names
CVS Pharmacy# 10289
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DORECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
215 BERGEN BLVD, FAIRVIEW, NJ 07022-1358
(201) 941-2180
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
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
—
0446173
—
NJ
01
—
3148726
NCPDP
—
Enumeration date
07/08/2014
Last updated
02/18/2015
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