Active NPI
Pennsylvania CVS Pharmacy LLC
Doing business as CVS Pharmacy # 04013
- Pharmacy
- Altoona, PA
National Provider Identifier
1679676423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- PP412905L
- Legal business name
- PENNSYLVANIA CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy # 04013
- Practice address
- 200 E Plank Rd
Altoona, PA 16602-4110 - Phone
- (814) 944-9224
- NPI assigned
- Sep 7, 2006
- Last updated
- Aug 3, 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 F Colbert
- Title
- Director
- Phone
- (401) 765-1500
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PP412905L | PA | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
200 E Plank Rd
Altoona, PA 16602-4110
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00754714 | Other | MEDICARE RR | |
| 3913907 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY # 04013
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080116000450 | PA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8527149566 | This NPI is an additional NPI on the enrollment |
| O20110506000013 | PA | DME Supplier - Pharmacy | 8527149566 | Practice locations: Altoona, PA |
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.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Pennsylvania CVS Pharmacy LLC | 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 |
National Provider Directory
National Provider Directory- Tax ID family
- Pennsylvania CVS Pharm
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.
-
dba CVS Pharmacy #16966
- Pharmacy
- Wilkes Barre Township, PA
- NPI 1699797332
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
200 E Plank Rd
Altoona, PA 16602
Phone (814) 944-9224
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1312329600000",
"number": "1679676423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "PO 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": "200 E PLANK RD",
"city": "ALTOONA",
"state": "PA",
"postal_code": "166024110",
"telephone_number": "814-944-9224"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PENNSYLVANIA CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2011-08-03",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "401-765-1500"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "PA",
"license": "PP412905L",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "P00754714",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3913907",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY # 04013",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Altoona, PA
- Michelle Victoria Pellegrino, CRNP
- Lindsey A Penezic, MD
- Penn Neuromuscular Diagnostics, LLC (PNDx)
- Penn State Altoona Health and Wellness Center
- Janet Kay Pennington, M.S.CCC-SLP
- Pennsylvania Department of Public Welfare (Altoona Center)
- Harry Penny
- Perfect Smile Dental of Altoona PC
- Perfect Smile Dental PC
- Peter C. Pham, DDS, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.