NPIMap

Organization Active NPI

Procare Pharmacy, L.L.C.

  • Pharmacy
  • San Francisco, CA
National Provider Identifier
1508975079
Registry record updated Jan 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHY49051
Legal business name
PROCARE PHARMACY, L.L.C.
Practice address
445 Castro St
San Francisco, CA 94114-2019
Phone
(800) 436-7119
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan Colbert
Title
Director Payer Relations
Phone
(401) 770-2751

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X PHY49051 Primary
Community/Retail Pharmacy 3336C0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

445 Castro St
San Francisco, CA 94114-2019

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
0519655OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1508975079MedicaidCA

Other names 1

  • CVS Pharmacy #02708 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930042934 CA DME Supplier - Pharmacy 5496643652 Practice locations: San Francisco, CA
O20110124000975 CA Part B Supplier - Mass Immunization (Roster Biller Only) 5496643652 1 other NPI on this enrollment
Practice locations: San Francisco, CA

Other NPIs with the same Medicare PAC ID 21

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

View all 21

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 #02708445 Castro St, San Francisco, CA 94114-2019(415) 864-7030 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 assignmentParticipating since Jan 1, 2023

National Provider Directory

National Provider Directory
Tax ID family
CVS Pharmacy 0270814 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Member of 1

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

Locations

3031 Telegraph Ave
Ste 115
Berkeley, CA 94705
Phone (510) 841-2211

445 Castro St
San Francisco, CA 94114
Phone (415) 864-7030

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612051200000",
    "number": "1508975079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "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": "445 CASTRO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941142019",
            "telephone_number": "800-436-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2021-01-31",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "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": "PHY49051",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0519655",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508975079",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #02708",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CVS Pharmacy #02708",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2021; 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.