Active NPI
Kentucky CVS Pharmacy LLC
Doing business as CVS Pharmacy # 10048
- Pharmacy
- Elizabethtown, KY
National Provider Identifier
1679904270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- KENTUCKY CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy # 10048
- Practice address
- 1571 N Dixie Hwy
Elizabethtown, KY 42701-2653 - Phone
- (270) 737-0352
- NPI assigned
- Dec 6, 2013
- Last updated
- Apr 11, 2014
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | NU | Primary | |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
1571 N Dixie Hwy
Elizabethtown, KY 42701-2653
Mailing address
1 CVS Dr
Box 1075 Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100277390 | Medicaid | KY | |
| 1834096 | Other | KY | NCPDP |
Other names 1
- CVS PHARMACY # 10048
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100927000455 | KY | Part B Supplier - Mass Immunization (Roster Biller Only) | 0143346239 | This NPI is an additional NPI on the enrollment |
| O20140318000226 | KY | DME Supplier - Pharmacy | 0143346239 | Practice locations: Elizabethtown, KY |
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 |
|---|---|---|
| CVS Pharmacy | 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
- Kentucky CVS Pharmacy 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.
-
- Pharmacy
- Shepherdsville, KY
- NPI 1649726258
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386288000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1397174400000",
"number": "1679904270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "BOX 1075 PHARMACY ENROLLMENTS",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146",
"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": "1571 N DIXIE HWY",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427012653",
"telephone_number": "270-737-0352"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KENTUCKY CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-12-06",
"last_updated": "2014-04-11",
"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": "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": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100277390",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "1834096",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY # 10048",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Elizabethtown, KY
- Jessica Renee Kennedy, BS OF ED, IECE
- Kathryn Kennedy, RDH
- Linda Kennedy, LPCC
- Kensington Health Center LLC (Kensington Center)
- Kentuckiana Foot & Ankle, PLLC
- Kentucky Heart and Vascular Specialists, PSC
- Kentucky Radiation Therapy Associates PSC
- Kelly Coriene Keplinger-Page, APRN
- Karen L Keplinger, RN
- Andrew James Kerr, PT DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; 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.