NPIMap

Organization Active NPI

Louisiana CVS Pharmacy, L.L.C.

Doing business as CVS Pharmacy # 1099

  • Pharmacy
  • Lake Charles, LA
National Provider Identifier
1487720314
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
5724 Issued in LA
Legal business name
LOUISIANA CVS PHARMACY, L.L.C.
Doing business as
CVS Pharmacy # 1099
Practice address
4828 Nelson Rd
Lake Charles, LA 70605
Phone
(337) 477-9068
NPI assigned
Nov 24, 2006
Last updated
Sep 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5724 LA Primary

Addresses

Primary practice location

4828 Nelson Rd
Lake Charles, LA 70605

Mailing address

One CVS Drive
Box 1075 - Pharmacy Enrollments
Woonsocket, RI 02895
Phone (401) 765-1500

Other identifiers 1

IdentifierTypeStateIssuer
691019MedicaidTX

Other names 1

  • CVS Pharmacy # 1099 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930046720 LA DME Supplier - Pharmacy 7113120312 Practice locations: Lake Charles, LA
O20101022000661 LA Part B Supplier - Mass Immunization (Roster Biller Only) 7113120312 This NPI is an additional NPI on the enrollment
Practice locations: Marksville, LA; Marrero, LA; Metairie, LA; Morgan City, LA; New Iberia, LA; Opelousas, LA; Plaquemine, LA; Ponchatoula, LA…

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
CVS Pharmacy #010994828 Nelson Rd, Lake Charles, LA 70605-5214(334) 477-9068 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 Jan 1, 2025

National Provider Directory

National Provider Directory
Tax ID family
Louisiana CVS Pharmacy120 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

4828 Nelson Rd
Lake Charles, LA 70605
Phone (337) 477-9068

Practitioners & affiliated clinicians

Practitioners 9

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": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505260800000",
    "number": "1487720314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE CVS DRIVE",
            "address_2": "BOX 1075 - PHARMACY ENROLLMENTS",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "02895",
            "telephone_number": "401-765-1500",
            "fax_number": "401-770-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4828 NELSON RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-477-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA CVS PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2017-09-13",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "LA",
            "license": "5724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691019",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy # 1099",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; 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.