NPIMap

Organization Active NPI

Pennsylvania CVS Pharmacy, L.L.C.

Doing business as CVS Pharmacy #01686

  • Pharmacy
  • Johnsonburg, PA
National Provider Identifier
1467556217
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PP412085L Issued in PA
Legal business name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Doing business as
CVS Pharmacy #01686
Practice address
236 Grant St
Johnsonburg, PA 15845-1024
Phone
(814) 965-2566
NPI assigned
Sep 12, 2006
Last updated
Mar 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X PP412085L PA Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

236 Grant St
Johnsonburg, PA 15845-1024

Mailing address

1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146

Other identifiers 1

IdentifierTypeStateIssuer
3957163OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • CVS PHARMACY #01686 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080116000450 PA Part B Supplier - Mass Immunization (Roster Biller Only) 8527149566 This NPI is an additional NPI on the enrollment
O20100930045357 PA DME Supplier - Pharmacy 8527149566 Practice locations: Johnsonburg, PA

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pennsylvania CVS Pharmacy LLC236 Grant St, Johnsonburg, PA 15845-1024(814) 965-2566 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 Dec 27, 2024

National Provider Directory

National Provider Directory
Tax ID family
Pennsylvania CVS Pharm431 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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations (25 of 26)

18700 North Village
#1524
Hagerstown, MD 21742
Phone (301) 791-0606

326 Market St
Berwick, PA 18603
Phone (570) 752-7462

639 Main St
Clarion, PA 16214
Phone (814) 226-7100

3055 Park Pl
Clearfield, PA 16830
Phone (814) 765-1241

115 Northumberland St
Danville, PA 17821
Phone (570) 275-1811

347 S Blakely St
Dunmore, PA 18512
Phone (570) 342-9138

635 Carlisle St
Hanover, PA 17331
Phone (717) 637-5228

651 Carey Ave
Hanover Township, PA 18706
Phone (570) 825-8111

236 Grant St
Johnsonburg, PA 15845
Phone (814) 965-2566

505 N Derr Dr
Lewisburg, PA 17837
Phone (570) 523-3261

120 E Walnut St
Lock Haven, PA 17745
Phone (570) 748-8260

1565 W Harrisburg Pike
Middletown, PA 17057
Phone (717) 944-9681

50 E Chestnut St
Mifflinburg, PA 17844
Phone (570) 966-3332

205 S Market St
Millersburg, PA 17061
Phone (717) 692-4725

37 Mahoning St
Milton, PA 17847
Phone (570) 742-3091

555 E Main St
Nanticoke, PA 18634
Phone (570) 735-2320

401 Duke St
Northumberlnd, PA 17857
Phone (570) 473-3221

300 Lycoming Mall Cir
Ste 107
Pennsdale, PA 17756
Phone (570) 546-8361

125 E Main St
Plymouth, PA 18651
Phone (570) 779-5334

110 Green Ridge St
Scranton, PA 18509
Phone (570) 344-7400

1000 N Market St
Selinsgrove, PA 17870
Phone (570) 374-2764

518 W Southern Ave
South Williamsport, PA 17702
Phone (570) 323-6090

405 N 4th St
Sunbury, PA 17801
Phone (570) 286-0739

220 Main St
Watsontown, PA 17777
Phone (570) 538-5184

1840 Lycoming Creek Rd
Williamsport, PA 17701
Phone (570) 323-1338

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1467556217",
    "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": "236 GRANT ST",
            "city": "JOHNSONBURG",
            "state": "PA",
            "postal_code": "158451024",
            "telephone_number": "814-965-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSYLVANIA CVS PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2012-03-09",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP412085L",
            "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": "3957163",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY #01686",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnsonburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.