Active NPI
CVS Albany LLC
Doing business as CVS Pharmacy 02414
- Pharmacy
- Johnson City, NY
National Provider Identifier
1043318686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 23706
- Legal business name
- CVS ALBANY LLC
- Doing business as
- CVS Pharmacy 02414
- Practice address
- 269 Harry L Dr
Johnson City, NY 13790-1422 - Phone
- (607) 729-3414
- NPI assigned
- Sep 20, 2006
- Last updated
- Apr 14, 2021
- 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 F Colbert
- Title
- Sr Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 23706 | NY | Primary |
| 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 names 1
- CVS PHARMACY 02414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
National Provider Directory- Tax ID family
- CVS Albany LLC 00560
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
269 Harry L Dr
Johnson City, NY 13790
Phone (607) 729-3414
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"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": [],
"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
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.