Organization
CVS PHARMACY INC
Active
Other names
CVS PHARMACY # 10227
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2907 CERRILLOS RD, SANTA FE, NM 87507-2310
(505) 471-4660
Mailing address
1 CVS DR, 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
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04374541
MEDICAID (NM) DME
—
01
—
3212557
NCPDP
—
05
—
65334248
—
NM
Enumeration date
08/13/2013
Last updated
05/15/2014
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