NPIMap

Organization Active NPI

Main Street Pharmacy, L.L.C.

Doing business as CVS Pharmacy #48594

  • Pharmacy
  • Highlands Ranch, CO
National Provider Identifier
1497529838
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MAIN STREET PHARMACY, L.L.C.
Doing business as
CVS Pharmacy #48594
Practice address
3235 Mill Vista Rd
Highlands Ranch, CO 80129-2440
Phone
(303) 583-1456
NPI assigned
Nov 7, 2023
Last updated
Feb 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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
Phone
(401) 770-2751

Specialties & licenses 3

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

Addresses

Primary practice location

3235 Mill Vista Rd
Highlands Ranch, CO 80129-2440

Mailing address

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

Other names 1

  • CVS Pharmacy #48594 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240304002025 CO DME Supplier - Pharmacy 7012037369 Practice locations: Highlands Ranch, CO

Other NPIs with the same Medicare PAC ID 15

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

View all 15

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 # 485943235 Mill Vista Rd, Highlands Ranch, CO 80129(303) 583-1456 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… Does not accept assignmentParticipating since Jan 1, 2025

National Provider Directory

National Provider Directory
Tax ID family
Main Street Pharmacy LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Locations

715 Maiden Choice Ln
#48271
Baltimore, MD 21228
Phone (410) 737-8820

3110 Gracefield Rd
#48275
Silver Spring, MD 20904
Phone (301) 572-8470

1 Cedar Crest Village Dr
#48303
Pompton Plains, NJ 07444
Phone (973) 831-3537

100 Maris Grove Way
#48331
Glen Mills, PA 19342
Phone (610) 387-4540

8000 Frankford Rd
Ste A
Dallas, TX 75252
Phone (214) 459-8873

NPI Registry JSON

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1497529838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR # 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500",
            "fax_number": "401-735-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 MILL VISTA RD",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292440",
            "telephone_number": "303-583-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-07",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SR DIRECTOR",
        "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": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #48594",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Highlands Ranch, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.