Active NPI
CVS Pharmacy Inc
Doing business as CVS Pharmacy 03292
- Pharmacy
- Wylie, TX
National Provider Identifier
1699879411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 24691
- Legal business name
- CVS PHARMACY INC
- Doing business as
- CVS Pharmacy 03292
- Practice address
- 750 W Kirby St
Wylie, TX 75098-3913 - Phone
- (972) 429-0836
- NPI assigned
- Sep 12, 2006
- Last updated
- Feb 17, 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
- Cristiana Mauricio
- Title
- MGR Phcy Enrollments
- Phone
- (401) 770-2937
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 24691 | TX | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
750 W Kirby St
Wylie, TX 75098-3913
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4522416 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY 03292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090408000170 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 5092711895 | This NPI is an additional NPI on the enrollment |
| O20100930033346 | TX | DME Supplier - Pharmacy | 5092711895 | Practice locations: Wylie, TX |
National Provider Directory
National Provider Directory- Tax ID family
- CVS Pharmacy Inc
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1424131200000",
"number": "1699879411",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 W KIRBY ST",
"city": "WYLIE",
"state": "TX",
"postal_code": "750983913",
"telephone_number": "972-429-0836"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CVS PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-12",
"last_updated": "2015-02-17",
"status": "A",
"authorized_official_last_name": "MAURICIO",
"authorized_official_first_name": "CRISTIANA",
"authorized_official_title_or_position": "MGR PHCY ENROLLMENTS",
"authorized_official_telephone_number": "401-770-2937"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "TX",
"license": "24691",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "4522416",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY 03292",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wylie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.