Arizona CVS Stores LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

ARIZONA CVS STORES LLC

Practice address

24865 N Lake Pleasant Parkway
Peoria, AZ 85383-1280

Phone

(623) 566-1110

NPI assigned

Apr 17, 2014

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

Director Payer Relations

Phone

(401) 770-2751

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• CVS PHARMACY #08952 Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ2 enrollments

Enrollment records 2

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

Tax ID family

Cvspharmacy 929364 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

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

• Arizona CVS Stores LLC

  • Pharmacy
  • Yuma, AZ
  • NPI 1003857046
  NPD tax ID
• Arizona CVS Stores LLC

  • Pharmacy
  • Yuma, AZ
  • NPI 1013952019
  NPD tax ID
• Arizona CVS Stores LLC

  • Pharmacy
  • Prescott, AZ
  • NPI 1033150941
  NPD tax ID
• Arizona CVS Stores LLC

  • Pharmacy
  • Parker, AZ
  • NPI 1053355305
  NPD tax ID
• Arizona CVS Stores LLC

  • Pharmacy
  • Sierra Vista, AZ
  • NPI 1063456317
  NPD tax ID
• Arizona CVS Stores LLC

  • Pharmacy
  • Peoria, AZ
  • NPI 1114961489
  NPD tax ID
• Arizona CVS Stores LLC

  • Pharmacy
  • Bullhead City, AZ
  • NPI 1134163488
  NPD tax ID
• Arizona CVS Stores LLC

  • Pharmacy
  • Cottonwood, AZ
  • NPI 1144264490
  NPD tax ID
• Arizona CVS Stores LLC

  • Pharmacy
  • Scottsdale, AZ
  • NPI 1194766147
  NPD tax ID
• Arizona CVS Stores LLC

  • Pharmacy
  • Phoenix, AZ
  • NPI 1235173600
  NPD tax ID
• Arizona CVS Stores LLC

  • Pharmacy
  • Tucson, AZ
  • NPI 1245274596
  NPD tax ID
• Arizona CVS Stores LLC

  • Pharmacy
  • Surprise, AZ
  • NPI 1285675223
  NPD tax ID

Member of 1

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

• CVS Pharmacy Inc

  • Pharmacy
  • Dallas, TX
  • NPI 1578667366

  Member Of

  NPD member

Locations (25 of 75)

Practitioners 140

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Reina Adil, PHARM D

  • Pharmacist
  • Phoenix, AZ
  • NPI 1982382990
  NPD (past)
• Jameel Al Rubaye

  • Pharmacist
  • Glendale, AZ
  • NPI 1790478519
  NPD (past)
• Maryam Aldabbagh, PHARMD

  • Pharmacist
  • Tucson, AZ
  • NPI 1851980510
  NPD (past)
• Sarah Jane Aldor, FNP

  • Family Nurse Practitioner
  • Tucson, AZ
  • NPI 1487930699
  NPD (past)
• Hyrum Allen

  • Pharmacist
  • Tucson, AZ
  • NPI 1053964213
  NPD (past)
• Giuliana Alvarez, APRN

  • Family Nurse Practitioner
  • Tucson, AZ
  • NPI 1154066702
  NPD (past)
• Godfrey Archibong

  • Pharmacist
  • Phoenix, AZ
  • NPI 1831787571
  NPD (past)
• Julia Ashley Assaid, PHARMD

  • Pharmacist
  • Yuma, AZ
  • NPI 1154298768
  NPD (past)
• Anthony Henry Ball, RPH

  • Pharmacist
  • Phoenix, AZ
  • NPI 1164799045
  NPD (past)
• Bradley David Baver, PHARM D

  • Pharmacist
  • Lake Havasu City, AZ
  • NPI 1619340049
  NPD (past)
• Lana Bengez-Pudja, PHARMD

  • Pharmacist
  • Surprise, AZ
  • NPI 1235542218
  NPD (past)
• Bernard Boateng

  • Pharmacist
  • Prescott Valley, AZ
  • NPI 1881155968
  NPD (past)

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410134400000",
    "number": "1134549181",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24865 N LAKE PLEASANT PARKWAY",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853831280",
            "telephone_number": "623-566-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA CVS STORES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-17",
        "last_updated": "2014-09-08",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926857",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0358778",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY #08952",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Peoria, AZ
• Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; 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.