Organization Active NPI

New Jersey CVS Pharmacy LLC

  • Pharmacy
  • Midland Park, NJ
National Provider Identifier
1013009596
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RS005091 Issued in NJ
Legal business name
NEW JERSEY CVS PHARMACY LLC
Practice address
80 Godwin Ave
Midland Park, NJ 07432-1951
Phone
(201) 670-9715
NPI assigned
Sep 29, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Susan Colbert
Title
Director
Phone
(401) 765-1500

Corporate family (same tax ID) 14

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #0051980 Godwin Ave, Midland Park, NJ 07432-1951(201) 670-9715 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 Mar 19, 2007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20100830000881 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 2365566288 This NPI is an additional NPI on the enrollment
O20100930036041 NJ DME Supplier - Pharmacy 3678777851 Practice locations: Midland Park, NJ

National Provider Directory

National Provider Directory
Tax ID family
New Jersey CVS Pharmacy LLC (336 organizations share this tax ID)

Locations

85 Godwin Ave
Midland Park, NJ 07432
Phone (201) 639-8870

80 Godwin Ave
Midland Park, NJ 07432
Phone (201) 447-0110

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X RS005091 NJ Primary
Community/Retail Pharmacy 3336C0003X

Addresses

NPPES NPI Registry

Primary practice location

80 Godwin Ave
Midland Park, NJ 07432-1951

Mailing address

1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
3136531OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

NPPES NPI Registry
  • CVS PHARMACY 00519 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 14, 2021.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620950400000",
    "number": "1013009596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "PO BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 GODWIN AVE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321951",
            "telephone_number": "201-670-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "401-765-1500"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "RS005091",
            "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": "3136531",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY 00519",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CVS PHARMACY 00519",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midland Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.