Active NPI
Rhode Island CVS Pharmacy LLC
Doing business as CVS pharmacy at Thundermist #02474
- Pharmacy
- Woonsocket, RI
National Provider Identifier
1154443125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- RHODE ISLAND CVS PHARMACY LLC
- Doing business as
- CVS pharmacy at Thundermist #02474
- Practice address
- 450 Clinton St
Woonsocket, RI 02895 - Phone
- (401) 235-6855
- NPI assigned
- Apr 3, 2007
- Last updated
- Feb 29, 2012
- 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, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | RI | ||
| Pharmacy | 333600000X | RI | Primary | |
| Community/Retail Pharmacy | 3336C0003X | RI | ||
| Specialty Pharmacy | 3336S0011X | RI |
Addresses
Primary practice location
450 Clinton St
Woonsocket, RI 02895
Mailing address
One CVS Drive
Box 1075 - Pharmacy Enrollments
Woonsocket, RI 02895
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4106933 | Other | RI | NCPDP |
| PP66708 | Medicaid | RI |
Other names 1
- CVS pharmacy at Thundermist #02474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090129000555 | RI | Part B Supplier - Mass Immunization (Roster Biller Only) | 5092879486 | This NPI is an additional NPI on the enrollment |
| O20110801000682 | RI | DME Supplier - Pharmacy | 5092879486 | Practice locations: Woonsocket, RI |
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 #02474 | Immunosuppressive 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|Urological Supplies|Ent… | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Ability Network
Organizations with this tax ID in the same state 23
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": "1175558400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1330473600000",
"number": "1154443125",
"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": "02895",
"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": "450 CLINTON ST",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "02895",
"telephone_number": "401-235-6855"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RHODE ISLAND CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-03",
"last_updated": "2012-02-29",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"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
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": "RI",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "4106933",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PP66708",
"state": "RI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS pharmacy at Thundermist #02474",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Woonsocket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.