Rhode Island CVS Pharmacy, L.L.C.

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHA00332 Issued in RI

Legal business name

RHODE ISLAND CVS PHARMACY, L.L.C.

Practice address

960 Broad St
Providence, RI 02905-1822

Phone

(410) 461-4383

NPI assigned

Sep 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cristiana Mauricio

Title

MGR Phcy Enrollments

Phone

(401) 770-2937

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• CVS PHARMACY # 04796 Doing business as

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

Member of 1

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

• CVS Pharmacy Inc

  • Pharmacy
  • Dallas, TX
  • NPI 1578667366

  Member Of

  NPD member

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402876800000",
    "number": "1093819898",
    "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": "960 BROAD ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029051822",
            "telephone_number": "410-461-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHODE ISLAND CVS PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2014-06-16",
        "status": "A",
        "authorized_official_last_name": "MAURICIO",
        "authorized_official_first_name": "CRISTIANA",
        "authorized_official_title_or_position": "MGR PHCY ENROLLMENTS",
        "authorized_official_telephone_number": "401-770-2937"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "RI",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "RI",
            "license": "PHA00332",
            "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": "4106313",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RI 75672",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY # 04796",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rhode Island College
• Rhode Island Companion Services LLC
• Rhode Island CVS Pharmacy LLC
• Rhode Island CVS Pharmacy, L.L.C.
• Rhode Island CVS Pharmacy, L.L.C.
• Rhode Island CVS Pharmacy, L.L.C.
• Rhode Island CVS Pharmacy, L.L.C.
• Rhode Island CVS Pharmacy, L.L.C.
• Rhode Island Dermatology and Laser Medicine
• Rhode Island Fingerprinting LLC

• Pharmacy in Providence, RI
• Providers in Providence, RI by specialty
• Pharmacy in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; 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.