Organization
ARKANSAS CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY # 10409
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
2402 N. COLLEGE AVENUE, FAYETTEVILLE, AR 72703-3308
(479) 251-1872
Mailing address
ONE CVS DRIVE, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
AR
333600000X
Pharmacy
Primary
—
AR
3336C0003X
Community/Retail Pharmacy
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0424820
NCPDP
AR
01
—
206422407
DME
AR
05
—
206422407
—
AR
Enumeration date
08/14/2014
Last updated
06/29/2015
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