Organization Active NPI

CVS Pharmacy Inc

  • Pharmacy
  • Clear Lake Shores, TX
National Provider Identifier
1104848860
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
CVS PHARMACY INC
Practice address
255 Marina Bay Dr
Clear Lake Shores, TX 77565-2671
Phone
(281) 538-7957
NPI assigned
Jul 24, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Susan Colbert
Title
Sr. Director, Payer Relations
Phone
(401) 770-2751

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #16716255 Marina Bay Dr, Clear Lake Shores, TX 77565-2671(281) 538-7957 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 Mar 12, 2025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090408000170 TX Part B Supplier - Mass Immunization (Roster Biller Only) 5092711895 This NPI is an additional NPI on the enrollment
O20161228001633 TX DME Supplier - Pharmacy 5092711895 Practice locations: Clear Lake Shores, TX

National Provider Directory

National Provider Directory
Tax ID family
CVS Pharmacy Inc Agent for CVS RX Services Inc1,253 organizations share this tax ID, including this one

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.

View all 24

Locations

255 Marina Bay Dr
Kemah, TX 77565
Phone (281) 538-7957

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

NPPES NPI Registry

Primary practice location

255 Marina Bay Dr
Clear Lake Shores, TX 77565-2671

Mailing address

1 CVS Dr
Mail Code 1090
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
465152MedicaidTX
2097001OtherPK

Other names 1

NPPES NPI Registry
  • CVS Pharmacy #16716 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 9, 2016.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1104848860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "MAIL CODE 1090",
            "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": "255 MARINA BAY DR",
            "city": "CLEAR LAKE SHORES",
            "state": "TX",
            "postal_code": "775652671",
            "telephone_number": "281-538-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2016-08-09",
        "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": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465152",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2097001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #16716",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clear Lake Shores, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.