CVS Albany LLC
Organization Active NPI Pharmacy · Gloversville, NY
NPI 1164520789 · NPPES record last updated May 22, 2014
Key facts
- NPI
- 1164520789
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 11071 (NY)
- Legal business name
- CVS ALBANY LLC
- Practice address
- 1013 State Highway 29a
Gloversville, NY 12078-5828 - Phone
- (518) 725-8661
- NPI assigned
- Sep 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan F Colbert
- Title
- Director Payer Relations
- Phone
- (401) 770-2751
Corporate family (same tax ID) 24
Member of 1
Practitioners 3
-
Kevin John Ash, RPH
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2261650 | CVS Pharmacy No 00793 | Certificate of waiver | Mar 26, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #00793 |
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… | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091103000102 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 0941347421 | This NPI is an additional NPI on the enrollment |
| O20100930044799 | NY | DME Supplier - Pharmacy | 0941347421 | Practice locations: Gloversville, NY |
| O20260501002874 | NY | Part B Supplier - Pharmacy | 0941347421 |
This NPI is an additional NPI on the enrollment Practice locations: Lindenhurst, NY |
National Provider Directory
- Tax ID family
- Cvscaremark
Locations
1013 State Highway 29A
Gloversville, NY 12078
Phone (518) 725-8661
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 11071 | NY | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
1013 State Highway 29a
Gloversville, NY 12078-5828
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3318056 | Other | NCPDP |
Other names
- CVS PHARMACY # 00793
Other providers in Gloversville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.