NPIMap

CVS Albany LLC

Organization Active NPI Pharmacy · Johnson City, NY

NPI 1043318686 · NPPES record last updated Apr 14, 2021

Key facts

NPI
1043318686
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
License
23706 (NY)
Legal business name
CVS ALBANY LLC
Practice address
269 Harry L Dr
Johnson City, NY 13790-1422
Phone
(607) 729-3414
NPI assigned
Sep 20, 2006
Organization subpart
No

Authorized official

Name
Susan F Colbert
Title
Sr Director, Payer Relations
Phone
(401) 770-2751

Corporate family (same tax ID) 24

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20091103000102 NY Part B Supplier - Mass Immunization (Roster Biller Only) 0941347421 This NPI is an additional NPI on the enrollment
O20100930017739 NY DME Supplier - Pharmacy 0941347421 Practice locations: Johnson City, NY
O20260501002874 NY Part B Supplier - Pharmacy 0941347421 This NPI is an additional NPI on the enrollment
Practice locations: Lindenhurst, NY

National Provider Directory

Tax ID family
Cvscaremark (525 organizations share this tax ID)

Locations

269 Harry L Dr
Johnson City, NY 13790
Phone (607) 729-3414

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 23706 NY Yes
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

269 Harry L Dr
Johnson City, NY 13790-1422

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
3342792OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names

  • CVS PHARMACY 02414 Doing business as

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1043318686",
    "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": "269 HARRY L DR",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901422",
            "telephone_number": "607-729-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS ALBANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SR DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "23706",
            "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": "3342792",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY 02414",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CVS PHARMACY 02414",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson City, NY

All providers in Johnson City, NY · Pharmacy in New York

Sources for this page

Verify at the official NPI Registry.