NPIMap

Organization Active NPI

CVS Health

  • Community/Retail Pharmacy
  • College Station, TX
National Provider Identifier
1205286374
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CVS HEALTH
Practice address
2100 Texas Ave S
College Station, TX 77840-3918
Phone
(979) 696-4368
NPI assigned
Jun 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Authorized official

Name
Hayden Wade Kopetsky, PHARM.D
Title
Pharmacist
Phone
(979) 774-1481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2100 Texas Ave S
College Station, TX 77840-3918

Mailing address

2100 Texas Ave S
College Station, TX 77840-3918

National Provider Directory

National Provider Directory
Tax ID family
Target33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Locations

2100 Texas Ave S
College Station, TX 77840
Phone (979) 696-4368

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1205286374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 TEXAS AVE S",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778403918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 TEXAS AVE S",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778403918",
            "telephone_number": "979-696-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "KOPETSKY",
        "authorized_official_first_name": "HAYDEN",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "979-774-1481",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.