Organization
CVS PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
9663 W. FM 1097, WILLIS, TX 77318
(936) 228-0204
Mailing address
BOX 1075, 1 CVS DR, WOONSOCKET, RI 02895
(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
—
471159
—
TX
01
—
5920233
NCPDP
TX
01
—
PH0708
MASS IMM
TX
Enumeration date
11/16/2016
Last updated
07/10/2017
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