Active NPI
Pennsylvania CVS Pharmacy LLC
Doing business as CVS Pharmacy # 05081
- Pharmacy
- Bala Cynwyd, PA
National Provider Identifier
1811276777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- PENNSYLVANIA CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy # 05081
- Practice address
- 101 W City Ave
Bala Cynwyd, PA 19004-3164 - Phone
- (610) 668-3890
- NPI assigned
- Aug 10, 2011
- Last updated
- Feb 22, 2012
- 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
- Director, Payer Relations
- Phone
- (401) 765-1500
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
101 W City Ave
Bala Cynwyd, PA 19004-3164
Mailing address
1 CVS Dr
P. O. Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811276777 | Other | PA | PACE |
| 1015538870397 | Medicaid | PA | |
| 3995810 | Other | PA | NCPDP |
Other names 1
- CVS Pharmacy # 05081
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080116000450 | PA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8527149566 | This NPI is an additional NPI on the enrollment |
| O20111222000130 | PA | DME Supplier - Pharmacy | 8527149566 | Practice locations: Bala Cynwyd, PA |
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.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #05081 | 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|Urological Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Parenteral Nutrients|Parenteral Equ… | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Pennsylavanis CVS Pharm
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.
-
- Pharmacy
- Bensalem, PA
- NPI 1801990692
-
dba CVS Pharmacy # 06763
- Community/Retail Pharmacy
- Perkasie, PA
- NPI 1831296334
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312934400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1329868800000",
"number": "1811276777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "P. O. BOX 1075",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146",
"telephone_number": "401-765-1500",
"fax_number": "401-770-7108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W CITY AVE",
"city": "BALA CYNWYD",
"state": "PA",
"postal_code": "190043164",
"telephone_number": "610-668-3890"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PENNSYLVANIA CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-08-10",
"last_updated": "2012-02-22",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR, PAYER RELATIONS",
"authorized_official_telephone_number": "401-765-1500"
},
"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": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACE",
"identifier": "1811276777",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1015538870397",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "3995810",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy # 05081",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bala Cynwyd, PA
- Paul Glat, MD PC
- Sally A. Pearne, PH.D.
- Penncare-Pennsylvania Hospitalist Associates
- Pennhurst Group LLC (Aveanna Healthcare)
- Pennsylvania CVS Pharmacy LLC (CVS Pharmacy # 05346)
- Christine Pereira, D.M.D
- Frederick S. Perez, DDS
- Nickeisha Perez, DMD
- Personal Touch Home Aides of PA, Inc.
- Personal Touch Home Aides of PA, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.