NPIMap

CVS Pharmacy Inc

Organization Active NPI Pharmacy · Elgin, TX

NPI 1629067103 · NPPES record last updated Feb 11, 2015

Key facts

NPI
1629067103
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
Legal business name
CVS PHARMACY INC
Practice address
1300 W US Highway 290
Elgin, TX 78621-2018
Phone
(512) 285-5552
NPI assigned
Oct 18, 2005
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

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

Practitioners 4

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #10337
1300 W US Highway 290, Elgin, TX 78621-1400 · (512) 285-5552		 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
Participating since Mar 12, 2025

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090408000170 TX Part B Supplier - Mass Immunization (Roster Biller Only) 5092711895 This NPI is an additional NPI on the enrollment
O20130415000449 TX DME Supplier - Pharmacy 5092711895 Practice locations: Elgin, TX

National Provider Directory

Tax ID family
CVS Pharmacy Inc Agent for CVS RX Services Inc (1,253 organizations share this tax ID)

Locations

115 N Main St
Elgin, TX 78621
Phone (512) 281-3838

Specialties & licenses

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

Addresses

Primary practice location

1300 W US Highway 290
Elgin, TX 78621-2018

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
466888MedicaidTX
4584567OtherNCPDP

Other names

  • CVS PHARMACY #10337 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 11, 2015.

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1629067103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "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": "1300 W US HIGHWAY 290",
            "city": "ELGIN",
            "state": "TX",
            "postal_code": "786212018",
            "telephone_number": "512-285-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2015-02-11",
        "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "466888",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4584567",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY #10337",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elgin, TX

All providers in Elgin, TX · Pharmacy in Texas

Sources for this page

Verify at the official NPI Registry.