Active NPI
New Jersey CVS Pharmacy LLC
Doing business as CVS Pharmacy 01243
- Pharmacy
- Newark, NJ
National Provider Identifier
1346332079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- RS005397
- Legal business name
- NEW JERSEY CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy 01243
- Practice address
- 451 Bloomfield Ave # 461
Newark, NJ 07107-1866 - Phone
- (201) 482-1063
- NPI assigned
- Sep 29, 2006
- Last updated
- Nov 12, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Colbert
- Title
- Director
- Phone
- (401) 765-1500
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | RS005397 | NJ | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
451 Bloomfield Ave # 461
Newark, NJ 07107-1866
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3138585 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY 01243
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100830000881 | NJ | Part B Supplier - Mass Immunization (Roster Biller Only) | 2365566288 | This NPI is an additional NPI on the enrollment |
| O20100930049518 | NJ | DME Supplier - Pharmacy | 3678777851 | Practice locations: Newark, NJ |
National Provider Directory
National Provider Directory- Tax ID family
- New Jersey CVS Pharm LLC
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.
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
451 Bloomfield Ave
#461
Newark, NJ 07107
Phone (201) 482-1063
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1289520000000",
"number": "1346332079",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 BLOOMFIELD AVE # 461",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071071866",
"telephone_number": "201-482-1063"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW JERSEY CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-29",
"last_updated": "2010-11-12",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "401-765-1500"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NJ",
"license": "RS005397",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3138585",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY 01243",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Newark, NJ
- New Horizons Behavioral Healthcare
- New Jersey Adult Medical Day Care Center II
- New Jersey Advanced Diagnostic Imaging
- New Jersey Anesthesia/Nbimc L.L.C (Millenium Anesthesia Consultants, LLC)
- New Jersey Coalition for Inclusive Education, Inc.
- New Jersey CVS Pharmacy LLC (CVS Pharmacy 02261)
- New Jersey CVS Pharmacy, L.L.C. (CVS Pharmacy #10527)
- New Jersey Electrophysiology Associates LLC
- New Jersey Home Care Society LLC
- New Jersey Medical School-Global Tuberculosis Institute
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; 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.