Organization
ARKANSAS CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY # 10779
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR-PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1122 S. UNIVERSITY AVE, LITTLE ROCK, AR 72204
(501) 660-4470
Mailing address
ONE CVS DRIVE, MAIL CODE 1090, 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
—
0425670
NCPDP
AR
05
—
215807407
—
AR
01
—
216638716
DME
AR
Enumeration date
06/21/2016
Last updated
11/22/2016
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