Active NPI
New Jersey CVS Pharmacy LLC
Doing business as CVS Pharmacy 01927
- Pharmacy
- Green Brook, NJ
National Provider Identifier
1104918689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- RS005215
- Legal business name
- NEW JERSEY CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy 01927
- Practice address
- 137 Route 22
Green Brook, NJ 08812 - Phone
- (732) 424-9242
- NPI assigned
- Sep 29, 2006
- Last updated
- Nov 12, 2010
- 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 Colbert
- Title
- Director
- Phone
- (401) 765-1500
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | RS005215 | NJ | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
137 Route 22
Green Brook, NJ 08812
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other names 1
- CVS PHARMACY 01927
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100830000881 | NJ | Part B Supplier - Mass Immunization (Roster Biller Only) | 2365566288 | This NPI is an additional NPI on the enrollment |
| O20100930010865 | NJ | DME Supplier - Pharmacy | 3678777851 | Practice locations: Green Brook, NJ |
National Provider Directory
National Provider Directory- Tax ID family
- New Jersey CVS Pharm LLC
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": "1159488000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1289520000000",
"number": "1104918689",
"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": "137 ROUTE 22",
"city": "GREEN BROOK",
"state": "NJ",
"postal_code": "08812",
"telephone_number": "732-424-9242"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW JERSEY CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-29",
"last_updated": "2010-11-12",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "401-765-1500"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NJ",
"license": "RS005215",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY 01927",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Green Brook, NJ
- Medexpress Urgent Care - New Jersey, Inc (MedExpress Urgent Care - Green Brook)
- Mega Care Inc. (Greenbrook Manor)
- Mega Care Inc. (Greenbrook Manor)
- Ronald P Meola, DC
- Merna Mikhail, MD
- Mary T Nowak, PAC
- Adetutu Zainab Ogunmefun, FNP, PMHNP-BC
- Sebastian Pawel Opar, PA-C
- Chinenye Angela Opara
- Karishma Patel
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; 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.