Iowa CVS Pharmacy, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

IOWA CVS PHARMACY, LLC

Practice address

545 W. Washington St
Council Bluffs, IA 51503-0771

Phone

(712) 352-4152

NPI assigned

Jan 13, 2011

Organization subpart

No

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 3

Addresses

Other identifiers 2

Other names 1

• CVS Pharmacy # 04816 Doing business as

Medicare fee-for-service enrollment

Enrolled in IA2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Iowa CVS Pharmacy LLC

  • Pharmacy
  • Waterloo, IA
  • NPI 1003838749

  O20071012000493

  Same enrollment
• Iowa CVS Pharmacy LLC

  • Pharmacy
  • Iowa City, IA
  • NPI 1013951482

  O20071012000493

  Same enrollment
• Iowa CVS Pharmacy LLC

  • Pharmacy
  • Ames, IA
  • NPI 1043232770

  O20071012000493

  Same enrollment
• Iowa CVS Pharmacy LLC

  • Pharmacy
  • Ankeny, IA
  • NPI 1043556988

  O20071012000493

  Same enrollment
• Iowa CVS Pharmacy LLC

  • Pharmacy
  • Cedar Rapids, IA
  • NPI 1063790178

  O20071012000493

  Same enrollment
• Iowa CVS Pharmacy LLC

  • Pharmacy
  • Davenport, IA
  • NPI 1134141864

  O20071012000493

  Same enrollment
• Iowa CVS Pharmacy LLC

  • Pharmacy
  • Des Moines, IA
  • NPI 1154344471

  O20071012000493

  Same enrollment
• Iowa CVS Pharmacy LLC

  • Pharmacy
  • Urbandale, IA
  • NPI 1194747832

  O20071012000493

  Same enrollment
• Iowa CVS Pharmacy LLC

  • Pharmacy
  • Davenport, IA
  • NPI 1194769562

  O20071012000493

  Same enrollment
• Iowa CVS Pharmacy LLC

  • Pharmacy
  • Fort Dodge, IA
  • NPI 1205261575

  O20071012000493

  Same enrollment
• Iowa CVS Pharmacy LLC

  • Pharmacy
  • Mason City, IA
  • NPI 1225050958

  O20071012000493

  Same enrollment
• Iowa CVS Pharmacy LLC

  • Pharmacy
  • West Des Moines, IA
  • NPI 1245253566

  O20071012000493

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

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 56)

Practitioners 38

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

• Ruben Agees Abraham, PHARMD

  • Pharmacist
  • Ankeny, IA
  • NPI 1134008444
  NPD (past)
• James Anderson, PHARMD

  • Pharmacist
  • Bettendorf, IA
  • NPI 1518385814
  NPD (past)
• Urvi Bhakta

  • Pharmacist
  • Waterloo, IA
  • NPI 1184346900
  NPD (past)
• Sarah Christine Boudinot

  • Pharmacist
  • Davenport, IA
  • NPI 1104420611
  NPD (past)
• Keely Nicole Bouska, PHARMD

  • Pharmacist
  • Council Bluffs, IA
  • NPI 1922603133
  NPD (past)
• Amy Braun, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Ames, IA
  • NPI 1063017283
  NPD (past)
• Noah James Budde

  • Pharmacist
  • Urbandale, IA
  • NPI 1528944717
  NPD (past)
• Michael Jerome Bukstein Jr., PHARM.D.

  • Pharmacist
  • Clive, IA
  • NPI 1023514767
  NPD (past)
• Rebecca Burgett, PHARMD

  • Pharmacist
  • Bettendorf, IA
  • NPI 1114522448
  NPD (past)
• Kellie Byrd, PHARMD

  • Pharmacist
  • Davenport, IA
  • NPI 1992309322
  NPD (past)
• Rachel Christensen

  • Pharmacist
  • Waterloo, IA
  • NPI 1588250757
  NPD (past)
• Mark Gardalen, PHARMD

  • Pharmacist
  • Ankeny, IA
  • NPI 1467055525
  NPD (past)

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1194020602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX - 1075 PHCY 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": "545 W. WASHINGTON ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515030771",
            "telephone_number": "712-352-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA CVS PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2012-03-06",
        "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": 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": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1623986",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194020602",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy # 04816",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Council Bluffs, IA
• Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.

Verify at the official NPI Registry.