NPIMap

Organization Active NPI

Rhode Island CVS Pharmacy, L.L.C.

Doing business as CVS Pharmacy # 02049

  • Pharmacy
  • Providence, RI
National Provider Identifier
1134360985
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
RHODE ISLAND CVS PHARMACY, L.L.C.
Doing business as
CVS Pharmacy # 02049
Practice address
39 Providence PL
Prov. Place Mall #1010.
Providence, RI 02903-1747
Phone
(401) 270-4440
NPI assigned
Mar 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Authorized official

Name
Susan Colbert
Title
Director, Payer Relations
Phone
(401) 770-2751

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X RI
Pharmacy 333600000X RI Primary
Community/Retail Pharmacy 3336C0003X RI

Addresses

Primary practice location

39 Providence PL
Prov. Place Mall #1010.
Providence, RI 02903-1747

Mailing address

One CVS Drive
Box 1075 - Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 3

IdentifierTypeStateIssuer
RI 75966MedicaidRI
3910052OtherRIDME
4107163OtherILNCPDP

Other names 1

  • CVS Pharmacy # 02049 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090129000555 RI Part B Supplier - Mass Immunization (Roster Biller Only) 5092879486 This NPI is an additional NPI on the enrollment
O20100930086040 RI DME Supplier - Pharmacy 5092879486 Practice locations: Providence, RI

Laboratory certificates & supplier records

Derived by NPIMap

These 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

SupplierSuppliesMedicare assignment
Rhode Island CVS Pharmacy, L.L.C.39 Providence PL, Providence, RI 02903-1747(401) 270-4440 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 assignmentParticipating since Dec 27, 2024

National Provider Directory

National Provider Directory
Tax ID family
Ability Network56 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Member of 1

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

Locations

39 Providence Pl
#1010
Providence, RI 02903
Phone (401) 270-4440

NPI Registry JSON

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

{
    "created_epoch": "1236384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1134360985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE CVS DRIVE",
            "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": "39 PROVIDENCE PL",
            "address_2": "PROV. PLACE MALL #1010.",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031747",
            "telephone_number": "401-270-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHODE ISLAND CVS PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-07",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "RI",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "RI",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "RI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RI 75966",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "3910052",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4107163",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy # 02049",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.

Verify at the official NPI Registry.