Organization
NORTH CAROLINA CVS PHARMACY LLC
Active
Other names
CVS Pharmacy #08935
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
6216 BATTLE BRIDGE RD, RALEIGH, NC 27610-1445
(919) 779-5651
Mailing address
1 CVS DR, BOX - 1075 PHARMACY ENROLLMENTS, 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
05
—
0920575
—
NC
01
—
3458216
NCPDP
NC
01
—
7705240
MEDICAID - DME
NC
Enumeration date
12/09/2010
Last updated
03/05/2012
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