Active NPI
Woodward Detroit CVS, L.L.C.
Doing business as CVS Pharmacy # 00211
- Pharmacy
- Brownstown Township, MI
National Provider Identifier
1669555165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 5301008501
- Legal business name
- WOODWARD DETROIT CVS, L.L.C.
- Doing business as
- CVS Pharmacy # 00211
- Practice address
- 18900 Telegraph Rd
Brownstown Township, MI 48174-9566 - Phone
- (734) 941-2067
- NPI assigned
- Oct 20, 2006
- Last updated
- Feb 15, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Colbert
- Title
- Director
- Phone
- (401) 765-1500
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | 5301008501 | MI | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
18900 Telegraph Rd
Brownstown Township, MI 48174-9566
Mailing address
One CVS Drive
Box 1075 - Pharmacy Enrollments
Woonsocket, RI 02895
Phone (401) 765-1500
Other names 1
- CVS Pharmacy # 00211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930086690 | MI | DME Supplier - Pharmacy | 4688875149 | Practice locations: Brownstown Township, MI |
| O20110208000865 | MI | Part B Supplier - Mass Immunization (Roster Biller Only) | 4688875149 | This NPI is an additional NPI on the enrollment |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2279353 | Woodward Detroit CVS, LLC CVS/Pharmacy #00211 | Certificate of waiver | Apr 2, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #00211 | 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… | Accepts assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Woodward Detroit CVS LLC
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.
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
18900 Telegraph Rd
Romulus, MI 48174
Phone (734) 941-2067
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Pharmacist
- Brownstown, MI
- NPI 1841864899
-
- Pharmacist
- Brownstown, MI
- NPI 1407486749
-
- Pharmacist
- Romulus, MI
- NPI 1134750094
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1297728000000",
"number": "1669555165",
"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": "18900 TELEGRAPH RD",
"city": "BROWNSTOWN TOWNSHIP",
"state": "MI",
"postal_code": "481749566",
"telephone_number": "734-941-2067"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOODWARD DETROIT CVS, L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-20",
"last_updated": "2011-02-15",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "401-765-1500"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "MI",
"license": "5301008501",
"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 # 00211",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Brownstown Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.