Active NPI
Wisconsin CVS Pharmacy LLC
Doing business as CVS Pharmacy #07147
- Pharmacy
- Madison, WI
National Provider Identifier
1467720037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- WISCONSIN CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy #07147
- Practice address
- 6701 Mineral Point Road
Madison, WI 53705-4241 - Phone
- (608) 833-3165
- NPI assigned
- Dec 9, 2011
- 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
- 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
6701 Mineral Point Road
Madison, WI 53705-4241
Mailing address
1 CVS Dr
Box 1075 - Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9113-12 | Other | WI | PHARMACY STATE LICENSE |
| 1467720037 | Medicaid | WI | |
| 5132927 | Other | WI | NCPDP |
Other names 1
- CVS PHARMACY #07147
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080110000070 | WI | Part B Supplier - Mass Immunization (Roster Biller Only) | 1658451059 | This NPI is an additional NPI on the enrollment |
| O20120328000873 | WI | DME Supplier - Pharmacy | 1658451059 | Practice locations: Madison, WI |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2225710 | Wisconsin CVS Pharmacy, LLC | Certificate of waiver | May 23, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #07147 | Immunosuppressive 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|Urological Supplies|Ent… | Accepts assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Wisconsin 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
6701 Mineral Point Rd
Madison, WI 53705
Phone (608) 833-3165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323388800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1467720037",
"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": "6701 MINERAL POINT ROAD",
"city": "MADISON",
"state": "WI",
"postal_code": "537054241",
"telephone_number": "608-833-3165"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WISCONSIN CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-12-09",
"last_updated": "2023-03-07",
"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
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY STATE LICENSE",
"identifier": "9113-12",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1467720037",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "5132927",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY #07147",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Madison, WI
- Wisconsin Care Solutions Corporation
- Wisconsin Care Transportation LLC
- Wisconsin Council of the Blind and Visually Impaired, Inc (Sharper Vision Store)
- Wisconsin CVS Pharmacy LLC (CVS Pharmacy #16450)
- Wisconsin CVS Pharmacy LLC (CVS Pharmacy #16445)
- Wisconsin CVS Pharmacy LLC (Target Pharmacy)
- Wisconsin CVS Pharmacy, L.L.C. (CVS Pharmacy #04930)
- Wisconsin Dental Group, S.C. (ForwardDental Madison West)
- Wisconsin Dental Group, S.C. (ForwardDental Madison East)
- Wisconsin Dialysis, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.