CVS Albany LLC
Organization Active NPI Pharmacy · Kingston, NY
NPI 1265734859 · NPPES record last updated Aug 12, 2011
Key facts
- NPI
- 1265734859
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- CVS ALBANY LLC
- Practice address
- 416 Washington Avenue
Kingston, NY 12401 - Phone
- (845) 331-0226
- NPI assigned
- Dec 2, 2010
- 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 4
-
Evan Tyler Banbury, PHARMD
-
Amanda Latimer, PHARMD
-
Daniel Schroedl, PHARMD
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #08945 |
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 |
| O20110308000048 | NY | DME Supplier - Pharmacy | 0941347421 | Practice locations: Kingston, 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
416 Washington Ave
Kingston, NY 12401
Phone (845) 331-0226
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Yes | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
416 Washington Avenue
Kingston, NY 12401
Mailing address
1 CVS Dr
Box 1075-Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03304818 | Medicaid | NY | |
| 5801469 | Other | NCPDP |
Other names
- CVS Pharmacy# 08945
Other providers in Kingston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2011. 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.