NPIMap

Organization Active NPI

Carecenter Pharmacy LLC

Doing business as Careplus CVS/Pharmacy #03108

  • Pharmacy
  • Menomonee Falls, WI
National Provider Identifier
1407007669
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
CARECENTER PHARMACY LLC
Doing business as
Careplus CVS/Pharmacy #03108
Practice address
W165N 5595 Creekwood Crossing
Menomonee Falls, WI 53051-5655
Phone
(262) 703-3386
NPI assigned
Oct 7, 2008
Last updated
Oct 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Authorized official

Name
Susan F Colbert
Title
Director, Payer Relations
Phone
(401) 770-2751

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

W165N 5595 Creekwood Crossing
Menomonee Falls, WI 53051-5655

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
5131228OtherNCPDP
1407007669MedicaidWI

Other names 1

  • CAREPLUS CVS/PHARMACY #03108 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930024328 WI DME Supplier - Pharmacy 0446456826 Practice locations: Menomonee Falls, WI
O20110210000204 WI Part B Supplier - Mass Immunization (Roster Biller Only) 0446456826 Practice locations: Menomonee Falls, WI

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1407007669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075-PHARMACY ENROLLMENTS",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W165N 5595 CREEKWOOD CROSSING",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530515655",
            "telephone_number": "262-703-3386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARECENTER PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "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": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5131228",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407007669",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAREPLUS CVS/PHARMACY #03108",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Menomonee Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.