NPIMap

Organization Active NPI

German Dobson CVS LLC

  • Pharmacy
  • Phoenix, AZ
National Provider Identifier
1003910993
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
3938 Issued in AZ
Legal business name
GERMAN DOBSON CVS LLC
Practice address
4040 N 19TH Ave
Phoenix, AZ 85015-5303
Phone
(602) 265-3167
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan Colbert
Title
Sr. Director, Payer Relations
Phone
(800) 746-7287

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 3938 AZ Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

4040 N 19TH Ave
Phoenix, AZ 85015-5303

Mailing address

1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 1

IdentifierTypeStateIssuer
0328179OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • CVS Pharmacy #05778 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100107000068 AZ Part B Supplier - Mass Immunization (Roster Biller Only) 0042351405 This NPI is an additional NPI on the enrollment
O20100930080458 AZ DME Supplier - Pharmacy 0042351405 Practice locations: Phoenix, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2226795German Dobson CVS, LLC Dba4040 N 19TH Ave, Phoenix, AZ 85015Certificate of waiverJun 2, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #057784040 N 19TH Ave, Phoenix, AZ 85015-5303(602) 265-3167 Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… Does not accept assignmentParticipating since Jan 1, 2025

National Provider Directory

National Provider Directory
Tax ID family
CVS132 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1003910993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500",
            "fax_number": "401-735-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155303",
            "telephone_number": "602-265-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERMAN DOBSON CVS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "800-746-7287"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AZ",
            "license": "3938",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0328179",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #05778",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.