Active NPI
CVS Albany LLC
Doing business as CVS Pharmacy# 10612
- Pharmacy
- Manhattan, NY
National Provider Identifier
1679973200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- CVS ALBANY LLC
- Doing business as
- CVS Pharmacy# 10612
- Practice address
- 65 5TH Ave
Manhattan, NY 10003-3003 - Phone
- (212) 255-0293
- NPI assigned
- Sep 2, 2014
- Last updated
- Jun 3, 2015
- 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
- Sr Director,Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
65 5TH Ave
Manhattan, NY 10003-3003
Mailing address
1 CVS Dr
Box 1075 Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04048871 | Medicaid | NY | |
| 5811509 | Other | NCPDP |
Other names 1
- CVS PHARMACY# 10612
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091103000102 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 0941347421 | This NPI is an additional NPI on the enrollment |
| O20150227001730 | NY | DME Supplier - Pharmacy | 0941347421 | Practice locations: New York, NY |
| O20260501002874 | NY | Part B Supplier - Pharmacy | 0941347421 |
This NPI is an additional NPI on the enrollment Practice locations: Lindenhurst, NY |
National Provider Directory
National Provider Directory- Tax ID family
- CVS Albany LLC 01925
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409616000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1433289600000",
"number": "1679973200",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 5TH AVE",
"city": "MANHATTAN",
"state": "NY",
"postal_code": "100033003",
"telephone_number": "212-255-0293"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CVS ALBANY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-09-02",
"last_updated": "2015-06-03",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "SR 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": "04048871",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "5811509",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY# 10612",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Manhattan, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.