NPIMap

Organization Active NPI

Alabama CVS Pharmacy, L.L.C.

Doing business as CVS Pharmacy #07217

  • Pharmacy
  • Tuscaloosa, AL
National Provider Identifier
1053415935
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
112621 Issued in AL
Legal business name
ALABAMA CVS PHARMACY, L.L.C.
Doing business as
CVS Pharmacy #07217
Practice address
4715 Rice Mine Rd NE
Tuscaloosa, AL 35406-2648
Phone
(205) 345-3455
NPI assigned
Sep 12, 2006
Last updated
Mar 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X 112621 AL Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

4715 Rice Mine Rd NE
Tuscaloosa, AL 35406-2648

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
1053415935MedicaidAL
1053415935OtherALDME
0132910OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • CVS Pharmacy #07217 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081211000091 AL Part B Supplier - Mass Immunization (Roster Biller Only) 1254492069 This NPI is an additional NPI on the enrollment
O20100930042972 AL DME Supplier - Pharmacy 1254492069 Practice locations: Tuscaloosa, AL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2264107Dba CVS/Pharmacy #072174715 Rice Mine Rd NE, Tuscaloosa, AL 35406Certificate of waiverJul 10, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #072174715 Rice Mine Rd NE, Tuscaloosa, AL 35406-2648(205) 345-3455 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 assignmentParticipating since Jan 1, 2025

National Provider Directory

National Provider Directory
Tax ID family
Alabama CVS Pharmacy LLC154 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Member 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1053415935",
    "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",
            "fax_number": "401-735-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 RICE MINE RD NE",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062648",
            "telephone_number": "205-345-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALABAMA CVS PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AL",
            "license": "112621",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053415935",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "1053415935",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0132910",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #07217",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.

Verify at the official NPI Registry.