Organization
CONNECTICUT CVS PHARMACY LLC
Active
Other names
CVS PHARMACY# 00556
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1657 RT 12, GALES FERRY, CT 06335-1533
(860) 464-0288
Mailing address
1 CVS DR, 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
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008042030
—
CT
01
—
008042745
DME
CT
01
—
0722860
NCPDP
—
Enumeration date
07/13/2012
Last updated
01/11/2013
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