Organization
OREGON CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 11150
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (SR DIRECTOR)
(401) 770-2751
Entity
Organization
Contact information
Practice address
12555 NW CORNELL RD, PORTLAND, OR 97229-5683
(503) 495-4157
Mailing address
1 CVS DR # 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
Enumeration date
09/11/2020
Last updated
10/28/2020
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