Organization
LOUISIANA CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY #05396
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
4890 BARKSDALE BLVD, BOSSIER CITY, LA 71112-4566
(318) 747-4330
(318) 746-2773
Mailing address
1 CVS DR, PO 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
5963
LA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001264971
—
LA
01
—
1918690
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
07/10/2014
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