NPIMap

Organization Active NPI

American Drug Stores Delaware LLC

Doing business as CVS Pharmacy #08614

  • Pharmacy
  • Bismarck, ND
National Provider Identifier
1730120601
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
AMERICAN DRUG STORES DELAWARE LLC
Doing business as
CVS Pharmacy #08614
Practice address
1225 E Calgary Avenue
Bismarck, ND 58503
Phone
(701) 223-9323
NPI assigned
Jun 9, 2006
Last updated
Oct 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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 NU
Pharmacy 333600000X NU Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

1225 E Calgary Avenue
Bismarck, ND 58503

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
3504328OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • CVS PHARMACY #08614 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070924000294 ND Part B Supplier - Mass Immunization (Roster Biller Only) 4688768492 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Minot, ND; Bismarck, ND; Grand Forks, ND; Fargo, ND
O20100930061515 ND DME Supplier - Pharmacy 4688768492 Practice locations: Bismarck, ND

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #086141225 E Calgary Ave, Bismarck, ND 58503-0610(701) 223-9323 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… Accepts assignmentParticipating since Jan 1, 2023

National Provider Directory

National Provider Directory
Tax ID family
American Drug Stores Delaware LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1225 E Calgary Ave
Bismarck, ND 58503
Phone (701) 223-9323

Practitioners & affiliated clinicians

Practitioners 5

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": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1730120601",
    "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": "1225 E CALGARY AVENUE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58503",
            "telephone_number": "701-223-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN DRUG STORES DELAWARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2011-10-07",
        "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": "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": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3504328",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY #08614",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.