Active NPI
Woodward Detroit CVS, LLC
Doing business as CVS Pharmacy # 10548
- Community/Retail Pharmacy
- Kalamazoo, MI
National Provider Identifier
1750741757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- WOODWARD DETROIT CVS, LLC
- Doing business as
- CVS Pharmacy # 10548
- Practice address
- 2600 W. Michigan Ave
Kalamazoo, MI 49006-5502 - Phone
- (269) 343-4232
- Fax
- (269) 216-9703
- NPI assigned
- Mar 3, 2016
- Last updated
- Oct 13, 2016
- 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 | |||
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
2600 W. Michigan Ave
Kalamazoo, MI 49006-5502
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2381971 | Other | MI | NCPDP |
| 1750741757 | Medicaid | MI |
Other names 1
- CVS PHARMACY # 10548
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110208000865 | MI | Part B Supplier - Mass Immunization (Roster Biller Only) | 4688875149 | This NPI is an additional NPI on the enrollment |
| O20160930001448 | MI | DME Supplier - Pharmacy | 4688875149 | Practice locations: Kalamazoo, MI |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2134217 | Woodward Detroit CVS, LLC | Certificate of waiver | May 19, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Woodward Detroit CVS LLC | 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 assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Woodward Detroit CVS LLC
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.
Locations
2600 W Michigan Ave
Kalamazoo, MI 49006
Phone (269) 343-4232
Practitioners & affiliated clinicians
Practitioners 4
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.
-
- Pharmacist
- Kalamazoo, MI
- NPI 1063017911
-
- Pharmacist
- Kalamazoo, MI
- NPI 1770238966
-
- Pharmacist
- Kalamazoo, MI
- NPI 1821621145
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456963200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1476316800000",
"number": "1750741757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "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": "2600 W. MICHIGAN AVE",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490065502",
"telephone_number": "269-343-4232",
"fax_number": "269-216-9703"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOODWARD DETROIT CVS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-03-03",
"last_updated": "2016-10-13",
"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": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "2381971",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1750741757",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY # 10548",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.