NPIMap

Organization Active NPI

CVS Pharmacy Inc

Doing business as CVS Pharmacy # 06961

  • Pharmacy
  • Weatherford, TX
National Provider Identifier
1720182561
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
24609 Issued in TX
Legal business name
CVS PHARMACY INC
Doing business as
CVS Pharmacy # 06961
Practice address
407 S Main St
Weatherford, TX 76086-5201
Phone
(817) 596-8374
Fax
(817) 594-7301
NPI assigned
Sep 12, 2006
Last updated
Mar 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Authorized official

Name
Susan Colbert
Title
Director, Payer Relations
Phone
(401) 770-2751

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X TX
Pharmacy 333600000X 24609 TX Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

407 S Main St
Weatherford, TX 76086-5201

Mailing address

1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 2

IdentifierTypeStateIssuer
4541896OtherOTHER ID NUMBER-COMMERCIAL NUMBER
000460888MedicaidTX

Other names 1

  • CVS PHARMACY # 06961 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090408000170 TX Part B Supplier - Mass Immunization (Roster Biller Only) 5092711895 This NPI is an additional NPI on the enrollment
O20100930068172 TX DME Supplier - Pharmacy 5092711895 Practice locations: Weatherford, TX

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
45D2256171CVS Pharmacy, Inc Dba CVS Pharmacy #06961407 S Main St, Weatherford, TX 76086Certificate of waiverMar 21, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #06961407 S Main St, Weatherford, TX 76086-5201(817) 596-8374 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 assignmentParticipating since Mar 12, 2025

National Provider Directory

National Provider Directory
Tax ID family
CVS Pharmacy1,253 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

Locations

407 S Main St
Weatherford, TX 76086
Phone (817) 596-8374

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": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1720182561",
    "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",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S MAIN ST",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865201",
            "telephone_number": "817-596-8374",
            "fax_number": "817-594-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "24609",
            "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": "4541896",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000460888",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY # 06961",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weatherford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.