Active NPI
Arizona CVS Stores LLC
Doing business as CVS Pharmacy 09294
- Pharmacy
- Peoria, AZ
National Provider Identifier
1114961489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- ARIZONA CVS STORES LLC
- Doing business as
- CVS Pharmacy 09294
- Practice address
- 9172 W Union Hills Dr
Peoria, AZ 85382-8177 - Phone
- (623) 572-0054
- NPI assigned
- Jun 16, 2006
- Last updated
- Dec 23, 2014
- 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 Pharmacy Enrollments
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | NU | Primary | |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
9172 W Union Hills Dr
Peoria, AZ 85382-8177
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0353944 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY 09294
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100107000345 | AZ | Part B Supplier - Mass Immunization (Roster Biller Only) | 6406997899 | This NPI is an additional NPI on the enrollment |
| O20100930008261 | AZ | DME Supplier - Pharmacy | 6406997899 | Practice locations: Peoria, AZ |
National Provider Directory
National Provider Directory- Tax ID family
- Cvscaremark
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1419292800000",
"number": "1114961489",
"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": "9172 W UNION HILLS DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853828177",
"telephone_number": "623-572-0054"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ARIZONA CVS STORES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-16",
"last_updated": "2014-12-23",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "DIRECTOR PHARMACY ENROLLMENTS",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"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": "0353944",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY 09294",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Peoria, AZ
- Arizona Christian Counseling LLC
- Arizona Community Pharmacy
- Arizona Consulting and Counseling Services
- Arizona Counseling Resources
- Arizona Courage Therapy, LLC
- Arizona CVS Stores LLC (CVS Pharmacy #08952)
- Arizona CVS Stores LLC (CVS Pharmacy 09237)
- Arizona CVS Stores LLC (CVS Pharmacy #03745)
- Arizona Dental Anesthesia PLLC
- Arizona Dental Professionals, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.