NPIMap

Organization Active NPI

CVS/Pharmacy

  • Community/Retail Pharmacy
  • Waterbury, CT
National Provider Identifier
1699124057
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0012919 Issued in CT
Legal business name
CVS/PHARMACY
Practice address
1279 W Main St
Waterbury, CT 06708-3101
Phone
(203) 755-5490
NPI assigned
Jun 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Authorized official

Name
Ms. Montanna J. Paulhus, PHARMD
Title
Pharmacy Manger
Phone
(603) 455-4312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 0012919 CT Primary

Addresses

Primary practice location

1279 W Main St
Waterbury, CT 06708-3101

Mailing address

1279 W Main St
Waterbury, CT 06708-3101
Phone (203) 755-5490

National Provider Directory

National Provider Directory
Tax ID family
CVS Caremark Corporation63 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1699124057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1279 W MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083101",
            "telephone_number": "203-755-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 W MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083101",
            "telephone_number": "203-755-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS/PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "PAULHUS",
        "authorized_official_first_name": "MONTANNA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PHARMACY MANGER",
        "authorized_official_telephone_number": "603-455-4312",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "0012919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.