Organization
CONNECTICUT CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY # 01154
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
6 WILLARD RD, NORWALK, CT 06851-4414
(203) 750-6901
Mailing address
1 CVS DR, PO BOX 1075, 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
1585
CT
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004162434
—
CT
01
—
004165412
STATE MEDICAID DME NUMBER
CT
01
—
0716780
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
03/28/2011
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