Active NPI
New Jersey CVS Pharmacy LLC
- Pharmacy
- Butler, NJ
National Provider Identifier
1417626847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- NEW JERSEY CVS PHARMACY LLC
- Practice address
- 1506 RT 23
Butler, NJ 07405 - Phone
- (973) 850-2015
- NPI assigned
- Sep 9, 2021
- Last updated
- Dec 13, 2021
- 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 F Colbert
- Title
- Sr Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
1506 RT 23
Butler, NJ 07405
Mailing address
1 CVS Drive
Box 1075
Woonsocket, RI 02895
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 |
| O20211208001187 | NJ | DME Supplier - Pharmacy | 3678777851 | Practice locations: Butler, NJ |
National Provider Directory
National Provider Directory- Tax ID family
- New Jersey CVS Pharmacy 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
1506 State Rt 23
Butler, NJ 07405
Phone (973) 492-9292
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631145600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1639353600000",
"number": "1417626847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DRIVE",
"address_2": "BOX 1075",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "02895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1506 RT 23",
"city": "BUTLER",
"state": "NJ",
"postal_code": "07405",
"telephone_number": "973-850-2015"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW JERSEY CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-09-09",
"last_updated": "2021-12-13",
"certification_date": "2021-12-13",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "SR 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
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Butler, NJ
- Jennifer McConville, PT
- Jeffrey Alan Michaels
- Emily Mari Miller, APN
- Kathleen Ann Minervini, MA, BCBA
- Muscle Fix Mobile LLC
- New Jersey Periodontics and Dental Implants LLC
- Leland Newman
- Dennis Michael Noonan, D.M.D.
- North Jersey Center for Arthritis & Osteoporosis
- Nursing Care, Incorporated (nursing care, inc)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.