NPIMap

Organization Active NPI

CVS Manchester NH, L.L.C

Doing business as CVS Pharmacy #01004

  • Pharmacy
  • Salem, NH
National Provider Identifier
1235212598
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
0134 P Issued in NH
Legal business name
CVS MANCHESTER NH, L.L.C
Doing business as
CVS Pharmacy #01004
Practice address
512 S Broadway
Salem, NH 03079-4306
Phone
(603) 898-5983
NPI assigned
Oct 23, 2006
Last updated
Mar 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 0134 P NH Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

512 S Broadway
Salem, NH 03079-4306

Mailing address

1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 2

IdentifierTypeStateIssuer
3004075OtherOTHER ID NUMBER-COMMERCIAL NUMBER
0423921MedicaidMA

Other names 1

  • CVS PHARMACY #01004 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100819000684 NH Part B Supplier - Mass Immunization (Roster Biller Only) 1850425356 48 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Merrimack, NH; Milford, NH; Nashua, NH; North Conway, NH; Peterborough, NH; Plaistow, NH; Plymouth, NH; Portsmouth, NH…
O20100930083108 NH DME Supplier - Pharmacy 1850425356 Practice locations: Salem, NH

Other NPIs on the same Medicare enrollment 45

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

View all 45

National Provider Directory

National Provider Directory

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": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1235212598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "PO BOX 1075",
            "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": "512 S BROADWAY",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030794306",
            "telephone_number": "603-898-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS MANCHESTER NH, L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "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": "NH",
            "license": "0134 P",
            "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": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3004075",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0423921",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY #01004",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CVS PHARMACY #01004",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.