Pennsylvania CVS Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

PENNSYLVANIA CVS PHARMACY LLC

Doing business as

CVS Pharmacy #17317

Practice address

913 Norland Ave
Chambersburg, PA 17201-4204

Phone

(717) 709-2060

Fax

(717) 709-2071

NPI assigned

Jan 11, 2007

Last updated

Dec 15, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan Colbert

Title

Sr. Director, Payer Relations

Phone

(401) 770-2751

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• CVS Pharmacy #17317 Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• CVS Pharmacy Inc.

  dba CVS Pharmacy #17247

  • Pharmacy
  • North Dartmouth, MA
  • NPI 1831271071

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481760000000",
    "number": "1134279482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 NORLAND AVE",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014204",
            "telephone_number": "717-709-2060",
            "fax_number": "717-709-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSYLVANIA CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2016-12-15",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
        "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": "PA",
            "license": "PP481695",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2081757",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #17317",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ricci Brooke Peck Costa, MSW
• Alexander Howard Peck, PHARMD
• Kayla Peck
• Pediatric Therapy Specialists of South Central PA, LLC
• Linda Louise Pelletier, P.T.
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #01649)
• Pennsylvania CVS Pharmacy. L.L.C. (CVS Pharmacy #01918)
• Elaina P Pepersack, PHARM D,
• Giannalise Marie Pepoli, OT
• Sharon Elizabeth Peppernick, PTA

• Pharmacy in Chambersburg, PA
• Providers in Chambersburg, PA by specialty
• Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.

Verify at the official NPI Registry.