Pennsylvania CVS Pharmacy, L.L.C.
Organization Active NPI Pharmacy · Schwenksville, PA
NPI 1104923697 · NPPES record last updated Aug 6, 2010
Key facts
- NPI
- 1104923697
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- PP415742L (PA)
- Legal business name
- PENNSYLVANIA CVS PHARMACY, L.L.C.
- Practice address
- 4290 TWP Line Rd
Schwenksville, PA 19473 - Phone
- (610) 222-2565
- NPI assigned
- Sep 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan Colbert
- Title
- Dir Phcy Enrollments
- Phone
- (401) 770-2804
Corporate family (same tax ID) 24
Member of 1
Practitioners 4
-
Deborah H Lee, PHARMD
-
Ruth Marie Musselman, RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080116000450 | PA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8527149566 | This NPI is an additional NPI on the enrollment |
| O20100930050230 | PA | DME Supplier - Pharmacy | 8527149566 | Practice locations: Schwenksville, PA |
National Provider Directory
- Tax ID family
- Pennsylvania CVS Pharmacy LLC
Locations
4290 Township Line Rd
Schwenksville, PA 19473
Phone (610) 222-2563
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | PP415742L | PA | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
4290 TWP Line Rd
Schwenksville, PA 19473
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3978547 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- CVS PHARMACY #02350
Other providers in Schwenksville, PA
- New Life Youth and Family Services
- Thai Quoc Nguyen
- John K Nuss
- Ortho Kinetic Rehab Inc
- Kristin Ann Parlatore
- Alana Pergine
- Physical Therapy Specialists of PA LLC
- Antoinette Marie Picard
- Donna M. Pitkoff
- Beth Ann Pope
All providers in Schwenksville, PA · Pharmacy in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.