NPIMap

New Jersey CVS Pharmacy, L.L.C.

Organization Active NPI Pharmacy · Toms River, NJ

NPI 1043665458 · NPPES record last updated Jan 24, 2017

Key facts

NPI
1043665458
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
Legal business name
NEW JERSEY CVS PHARMACY, L.L.C.
Practice address
1357 Lakewood Rd
Toms River, NJ 08755-4021
Phone
(732) 244-2376
NPI assigned
May 4, 2016
Organization subpart
No

Authorized official

Name
Susan Colbert
Title
Sr. Director- Payer Relations
Phone
(401) 765-1500

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.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2282432New Jersey CVS Pharmacy, LLC
1357 Lakewood Road, Toms River, NJ 08755		Certificate of waiverMay 21, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
New Jersey CVS Pharmacy LLC
1357 Lakewood Rd, Toms River, NJ 08755-4021 · (732) 244-2376		 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
Participating since Mar 19, 2007

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100830000881 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 2365566288 This NPI is an additional NPI on the enrollment
O20161119000412 NJ DME Supplier - Pharmacy 3678777851 Practice locations: Toms River, NJ

National Provider Directory

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

Locations

1357 Lakewood Rd
Toms River, NJ 08755
Phone (732) 244-2376

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NJ
Pharmacy 333600000X NJ Yes
Community/Retail Pharmacy 3336C0003X NJ

Addresses

Primary practice location

1357 Lakewood Rd
Toms River, NJ 08755-4021

Mailing address

1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers

IdentifierTypeStateIssuer
0543314MedicaidNJ
3151759OtherNJNCPDP

Other names

  • CVS PHARMACY # 10608 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 Jan 24, 2017.

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485216000000",
    "number": "1043665458",
    "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",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 LAKEWOOD RD",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087554021",
            "telephone_number": "732-244-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY CVS PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-04",
        "last_updated": "2017-01-24",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR. DIRECTOR- PAYER RELATIONS",
        "authorized_official_telephone_number": "401-765-1500"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0543314",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3151759",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY # 10608",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Toms River, NJ

All providers in Toms River, NJ · Pharmacy in New Jersey

Sources for this page

Verify at the official NPI Registry.