Active NPI
CVS Albany LLC
Doing business as CVS Pharmacy # 02164
- Pharmacy
- Mount Vernon, NY
National Provider Identifier
1073617833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 23465
- Legal business name
- CVS ALBANY LLC
- Doing business as
- CVS Pharmacy # 02164
- Practice address
- 211 East Sanford Blvd
Mt Vernon, NY 10550 - Phone
- (914) 664-9250
- NPI assigned
- Sep 12, 2006
- Last updated
- Aug 12, 2014
- 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
- Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 23465 | NY | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
211 East Sanford Blvd
Mt Vernon, NY 10550
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3330836 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY # 02164
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 |
| O20100930059785 | NY | DME Supplier - Pharmacy | 0941347421 | Practice locations: Mount Vernon, 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
- Cvscaremark
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.
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": "1407801600000",
"number": "1073617833",
"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",
"telephone_number": "401-765-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 EAST SANFORD BLVD",
"city": "MT VERNON",
"state": "NY",
"postal_code": "10550",
"telephone_number": "914-664-9250"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CVS ALBANY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-12",
"last_updated": "2014-08-12",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"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": "NY",
"license": "23465",
"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": "3330836",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY # 02164",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mount Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; 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.