Organization
PENNSYLVANIA CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY #01920
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIR PHCY ENROLLMENTS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
833 BOWMAN ST THE PROMENADE AT LEBANON E, LEBANON, PA 17046
(717) 274-1463
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
PP414316L
PA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3965855
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/20/2006
Last updated
08/13/2010
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