NPIMap

Organization Active NPI

Woodward Detroit CVS, LLC

Doing business as CVS Pharmacy # 10137

  • Community/Retail Pharmacy
  • Holland, MI
National Provider Identifier
1679822381
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WOODWARD DETROIT CVS, LLC
Doing business as
CVS Pharmacy # 10137
Practice address
132 Douglas Ave.
Holland, MI 49424-6514
Phone
(616) 396-2959
NPI assigned
Sep 10, 2012
Last updated
Sep 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Authorized official

Name
Susan F Colbert
Title
Director, Payer Relations
Phone
(401) 765-1500

Specialties & licenses 3

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

Addresses

Primary practice location

132 Douglas Ave.
Holland, MI 49424-6514

Mailing address

One CVS Drive
Woonsocket, RI 02895-6164
Phone (401) 765-1500

Other identifiers 2

IdentifierTypeStateIssuer
2377150OtherMINCPDP
1679822381MedicaidMI

Other names 1

  • CVS PHARMACY # 10137 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110208000865 MI Part B Supplier - Mass Immunization (Roster Biller Only) 4688875149 This NPI is an additional NPI on the enrollment
O20121103000034 MI DME Supplier - Pharmacy 4688875149 Practice locations: Holland, MI

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2189684Woodward Detroit CVS, LLC132 Douglas Avenue, Holland, MI 49424Certificate of waiverAug 3, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Woodward Detroit CVS LLC132 Douglas Ave, Holland, MI 49424-6514(616) 396-2959 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 assignmentParticipating since Jan 1, 2023

National Provider Directory

National Provider Directory
Tax ID family
Woodward Detroit CVS LLC219 organizations share this tax ID, including this one

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.

View all 24

Member of 1

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

Locations

132 Douglas Ave
Holland, MI 49424
Phone (616) 396-2959

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1679822381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE CVS DRIVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956164",
            "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": "132 DOUGLAS AVE.",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494246514",
            "telephone_number": "616-396-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODWARD DETROIT CVS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2013-09-17",
        "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": "401-765-1500"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2377150",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679822381",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY # 10137",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.