Active NPI
Kentucky CVS Pharmacy, L.L.C.
Doing business as CVS Pharmacy# 06941
- Pharmacy
- Lexington, KY
National Provider Identifier
1104929850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- P06042
- Legal business name
- KENTUCKY CVS PHARMACY, L.L.C.
- Doing business as
- CVS Pharmacy# 06941
- Practice address
- 118 E New Circle Rd
Lexington, KY 40505-2115 - Phone
- (859) 254-1325
- NPI assigned
- Sep 7, 2006
- Last updated
- Mar 27, 2020
- 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
- Phone
- (401) 765-1500
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | P06042 | KY | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
118 E New Circle Rd
Lexington, KY 40505-2115
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1816923 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY# 06941
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100927000455 | KY | Part B Supplier - Mass Immunization (Roster Biller Only) | 0143346239 | This NPI is an additional NPI on the enrollment |
| O20100930022243 | KY | DME Supplier - Pharmacy | 0143346239 | Practice locations: Lexington, KY |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D2282220 | Kentucky CVS Pharmacy, LLC Dba | Certificate of waiver | May 17, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #06941 | 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 assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Kentucky CVS Pharmacy LLC
Organizations with this tax ID in the same state 19
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.
Locations
118 E New Circle Rd
Lexington, KY 40505
Phone (859) 254-1325
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1585267200000",
"number": "1104929850",
"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": "118 E NEW CIRCLE RD",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405052115",
"telephone_number": "859-254-1325"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KENTUCKY CVS PHARMACY, L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2020-03-27",
"certification_date": "2020-03-27",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"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": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "KY",
"license": "P06042",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "1816923",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY# 06941",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CVS PHARMACY# 06941",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lexington, KY
- Kentucky Center for Vision PSC (Koffler Vision Group)
- Kentucky Centers for Infant Maternal and Lactation Care LLC
- Kentucky Children's Hospital
- Kentucky CVS Pharmacy LLC (CVS Pharmacy #17759)
- Kentucky CVS Pharmacy, L.L.C (CVS Pharmacy# 06942)
- Kentucky CVS Pharmacy, L.L.C. (CVS Pharmacy # 06940)
- Kentucky Dermatology and Skin Cancer Clinic, PSC
- Kentucky Dermatology Obs Lexington
- Kentucky Dermatology Obs London Inc
- Kentucky Doulas, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.