Active NPI
Iowa CVS Pharmacy LLC
- Pharmacy
- Ankeny, IA
National Provider Identifier
1043556988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- IOWA CVS PHARMACY LLC
- Practice address
- 104 E. 1St St
Ankeny, IA 50021-1703 - Phone
- (515) 963-7889
- NPI assigned
- Dec 21, 2012
- 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, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
104 E. 1St St
Ankeny, IA 50021-1703
Mailing address
1 CVS Dr
Box 1075 - Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043556988 | Medicaid | IA | |
| 1624419 | Other | IA | NCPDP |
Other names 1
- CVS Pharmacy # 10114
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071012000493 | IA | Part B Supplier - Mass Immunization (Roster Biller Only) | 3577659127 |
37 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Council Bluffs, IA |
| O20130510000327 | IA | DME Supplier - Pharmacy | 3577659127 | Practice locations: Ankeny, IA |
Other NPIs on the same Medicare enrollment 33
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese 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
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #10114 | 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 assignment |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Ankeny, IA
- NPI 1134008444
-
- Pharmacist
- Ankeny, IA
- NPI 1467055525
-
- Pharmacist
- Ankeny, IA
- NPI 1720682073
-
- Pharmacist
- Ankeny, IA
- NPI 1487532933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356048000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1368576000000",
"number": "1043556988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "BOX 1075 - PHARMACY ENROLLMENTS",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146",
"telephone_number": "401-765-1500",
"fax_number": "401-770-7108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 E. 1ST ST",
"city": "ANKENY",
"state": "IA",
"postal_code": "500211703",
"telephone_number": "515-963-7889"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IOWA CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-12-21",
"last_updated": "2013-05-15",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR, PAYER RELATIONS",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1043556988",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "1624419",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy # 10114",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Ankeny, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.