Active NPI
New Jersey CVS Pharmacy LLC
Doing business as CVS Pharmacy# 06544
- Pharmacy
- Maple Shade, NJ
National Provider Identifier
1033476387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- NEW JERSEY CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy# 06544
- Practice address
- 2920 Route 73 N
Store#1
Maple Shade, NJ 08052-2058 - Phone
- (856) 667-2811
- NPI assigned
- Apr 11, 2012
- Last updated
- Feb 1, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Colbert
- Title
- Director
- Phone
- (401) 765-1500
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | NU | Primary | |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
2920 Route 73 N
Store#1
Maple Shade, NJ 08052-2058
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3198644 | Other | NCPDP | |
| 0309761 | Medicaid | NJ |
Other names 1
- CVS PHARMACY# 06544
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100830000881 | NJ | Part B Supplier - Mass Immunization (Roster Biller Only) | 2365566288 | This NPI is an additional NPI on the enrollment |
| O20120806000037 | NJ | DME Supplier - Pharmacy | 2365566288 | Practice locations: Maple Shade, NJ |
National Provider Directory
National Provider Directory- Tax ID family
- New Jersey CVS Pharm LLC
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
2920 Route 73 N
Ste 1
Maple Shade, NJ 08052
Phone (856) 667-2811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334102400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1359676800000",
"number": "1033476387",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2920 ROUTE 73 N",
"address_2": "STORE#1",
"city": "MAPLE SHADE",
"state": "NJ",
"postal_code": "080522058",
"telephone_number": "856-667-2811"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW JERSEY CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-04-11",
"last_updated": "2013-02-01",
"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": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "3198644",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0309761",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY# 06544",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Maple Shade, NJ
- Merakey New Jersey
- Merakey New Jersey
- Multi-Cultural Learning Center and Therapeutic Services Inc.
- Jocelyn Muse-Taylor
- Neurological Regional Associates, P.a.
- New Jersey Mental Health and Nutritional Group LLC
- Faith Niemcewicz, LPC
- Kevin P Norton, D.O.
- Orthocare Pain and Rehabilitation Medicine LLC
- Danelle Parker-Mason, LSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.