Louisiana CVS Pharmacy LLC
Organization Active NPI Pharmacy · Lake Charles, LA
NPI 1588686232 · NPPES record last updated Oct 5, 2016
Key facts
- NPI
- 1588686232
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- LOUISIANA CVS PHARMACY LLC
- Practice address
- 1720 W Prien Lake Rd
Lake Charles, LA 70601-8361 - Phone
- (337) 562-7802
- Fax
- (337) 656-4903
- NPI assigned
- Jul 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan Colbert
- Title
- Sr. Director, Payer Relations
- Phone
- (401) 770-2751
Corporate family (same tax ID) 24
Member of 1
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #16738 |
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 assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101011000003 | LA | Part B Supplier - Mass Immunization (Roster Biller Only) | 7113120312 | This NPI is an additional NPI on the enrollment |
| O20160826000106 | LA | DME Supplier - Pharmacy | 7113120312 | Practice locations: Lake Charles, LA |
National Provider Directory
- Tax ID family
- CVS Pharmacy LLC
Locations
1720 W Prien Lake Rd
Lake Charles, LA 70601
Phone (337) 562-7802
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Yes | ||
| Community/Retail Pharmacy | 3336C0003X | PHY.007342-RC | LA |
Addresses
Primary practice location
1720 W Prien Lake Rd
Lake Charles, LA 70601-8361
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2035054 | Other | PK |
Other names
- CVS Pharmacy #16738
Other providers in Lake Charles, LA
- Dakota Loosemore
- Frank W Lopez
- Jonathan Blaine Lopez
- Lindsay Lopez
- Louisiana Chiropractic and Wellness
- Louisiana CVS Pharmacy, L.L.C.
- Louisiana CVS Pharmacy, L.L.C.
- Louisiana CVS Pharmacy, L.L.C.
- Louisiana Dental Professionals, Donovan Dronet, DDS, a Professional de
- Louisiana Em-I Medical Services, a Medical Corporation
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.