NPIMap

Organization Active NPI

Connecticut CVS Pharmacy LLC

  • Pharmacy
  • Brookfield, CT
National Provider Identifier
1831293737
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
1210 Issued in CT
Legal business name
CONNECTICUT CVS PHARMACY LLC
Practice address
14 Candlewood Lake Rd
Brookfield, CT 06804-2529
Phone
(203) 775-2709
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Authorized official

Name
Susan F Colbert
Title
Director, Payer Relations
Phone
(401) 765-1500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 1210 CT Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

14 Candlewood Lake Rd
Brookfield, CT 06804-2529

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0710663OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • CVS PHARMACY # 00696 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930074373 CT DME Supplier - Pharmacy 7214139633 Practice locations: Brookfield, CT
O20101105000131 CT Part B Supplier - Mass Immunization (Roster Biller Only) 7214139633 This NPI is an additional NPI on the enrollment

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 #0069614 Candlewood Lake Rd, Brookfield, CT 06804-2529(203) 775-9593 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 Jan 1, 2025

National Provider Directory

National Provider Directory
Tax ID family
Connecticut CVS Pharmacy LLC167 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

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": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1831293737",
    "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": "14 CANDLEWOOD LAKE RD",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042529",
            "telephone_number": "203-775-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "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": "CT",
            "license": "1210",
            "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": "0710663",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY # 00696",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookfield, CT

Sources for this page

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

Verify at the official NPI Registry.