Organization
ARIZONA CVS STORES LLC
Active
Other names
CVS PHARMACY 07022
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR PHCY ENROLLMENTS)
(401) 765-2751
Entity
Organization
Contact information
Practice address
75 LAKE HAVASU AVE N, LAKE HAVASU CITY, AZ 86403-5651
(928) 854-6300
Mailing address
1 CVS DR, BOX 1075--PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
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
01
—
0355190
NCPDP
AZ
05
—
318108
—
AZ
Enumeration date
01/24/2008
Last updated
05/05/2015
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