Active NPI
New Jersey CVS Pharmacy LLC
Doing business as CVS Pharmacy # 02949
- Pharmacy
- East Hanover, NJ
National Provider Identifier
1104977065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- RS00614500
- Legal business name
- NEW JERSEY CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy # 02949
- Practice address
- 451 Ridgedale Ave
East Hanover, NJ 07936-1437 - Phone
- (973) 463-3301
- NPI assigned
- Jan 16, 2007
- Last updated
- Nov 16, 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 | 4616190001 | NJ | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | RS00614500 | NJ | Primary |
Addresses
Primary practice location
451 Ridgedale Ave
East Hanover, NJ 07936-1437
Mailing address
1 CVS Dr
Box 1075 - Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3144463 | Other | NCPDP | |
| 8929408 | Medicaid | NJ |
Other names 1
- CVS Pharmacy # 02949
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 |
| O20100930019508 | NJ | DME Supplier - Pharmacy | 3678777851 | Practice locations: East Hanover, NJ |
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.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #02949 | 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
- 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": "1168905600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1289865600000",
"number": "1104977065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "BOX 1075 - PHARMACY ENROLLMENTS",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146",
"telephone_number": "401-765-1500",
"fax_number": "401-770-7108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 RIDGEDALE AVE",
"city": "EAST HANOVER",
"state": "NJ",
"postal_code": "079361437",
"telephone_number": "973-463-3301"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW JERSEY CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-16",
"last_updated": "2010-11-16",
"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": "NJ",
"license": "4616190001",
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NJ",
"license": "RS00614500",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "3144463",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8929408",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy # 02949",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in East Hanover, NJ
- Natty Bandasak Physio Performance (Myokinetix)
- Nazarri Sportscare
- Joseph Thomas Nazzari
- Neuro Pro Wellness LLC (Neuro Home Wellness LLC)
- Neuropsychological and Psychodiagnostic Assessment Center of NJ
- New Jersey CVS Pharmacy LLC (CVS Pharmacy #16823)
- Natalie Nieves
- Kate A Okusanya, NP
- Natalia Olarte, LCSW
- Jessica J Olivera Sokol
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.