NPIMap

Organization Active NPI

CVS Pharmacy Inc

  • Pharmacy
  • San Antonio, TX
National Provider Identifier
1306148473
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
CVS PHARMACY INC
Practice address
15038 Nacogdoches Rd
San Antonio, TX 78247-1210
Phone
(210) 646-7045
NPI assigned
Nov 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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 TX
Pharmacy 333600000X TX Primary
Community/Retail Pharmacy 3336C0003X TX

Addresses

Primary practice location

15038 Nacogdoches Rd
San Antonio, TX 78247-1210

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
5901839OtherTXNCPDP
280676201OtherTXMEDICAID DME
466720MedicaidTX

Other names 1

  • CVS Pharmacy # 05858 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090408000170 TX Part B Supplier - Mass Immunization (Roster Biller Only) 5092711895 This NPI is an additional NPI on the enrollment
O20110414000110 TX DME Supplier - Pharmacy 5092711895 Practice locations: San Antonio, TX

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2281966CVS Pharmarcy, Inc Dba CVS/Pharmacy #0585815038 Nacogdoches Rd, San Antonio, TX 78247Certificate of waiverMay 14, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #0585815038 Nacogdoches Rd, San Antonio, TX 78247-1210(210) 646-7045 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… Does not accept assignmentParticipating since Mar 12, 2025

National Provider Directory

National Provider Directory
Tax ID family
CVS Pharmacy Inc Agent for CVS RX Services Inc1,253 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1306148473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "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": "15038 NACOGDOCHES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782471210",
            "telephone_number": "210-646-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-23",
        "last_updated": "2011-11-23",
        "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": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5901839",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "280676201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "466720",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy # 05858",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.