NPIMap

CVS Manchester NH LLC

Organization Active NPI Pharmacy · Manchester, NH

NPI 1063595320 · NPPES record last updated Jun 13, 2014

Key facts

NPI
1063595320
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
License
0168 P (NH)
Legal business name
CVS MANCHESTER NH LLC
Practice address
788 S Willow St
Manchester, NH 03103-4018
Phone
(603) 668-4637
NPI assigned
Oct 23, 2006
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 45

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 45

Corporate family (same tax ID) 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 3

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy 200
788 S Willow St, Manchester, NH 03103-4018 · (603) 668-4637		 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 Jan 1, 2019

Medicare participation

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

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100819000684 NH Part B Supplier - Mass Immunization (Roster Biller Only) 1850425356 48 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Merrimack, NH; Milford, NH; Nashua, NH; North Conway, NH; Peterborough, NH; Plaistow, NH; Plymouth, NH; Portsmouth, NH…
O20100930092173 NH DME Supplier - Pharmacy 1850425356 Practice locations: Manchester, NH

National Provider Directory

Tax ID family
CVS Manchester NH L L C (42 organizations share this tax ID)

Locations

788 S Willow St
Manchester, NH 03103
Phone (603) 668-4637

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 0168 P NH Yes
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

788 S Willow St
Manchester, NH 03103-4018

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
3003314OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names

  • CVS PHARMACY 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 Jun 13, 2014.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402617600000",
    "number": "1063595320",
    "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": "788 S WILLOW ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031034018",
            "telephone_number": "603-668-4637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS MANCHESTER NH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2014-06-13",
        "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": "NH",
            "license": "0168 P",
            "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": "3003314",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, NH

All providers in Manchester, NH · Pharmacy in New Hampshire

Sources for this page

Verify at the official NPI Registry.