Pennsylvania CVS Pharmacy LLC
Organization Active NPI Community/Retail Pharmacy · Perkasie, PA
NPI 1831296334 · NPPES record last updated Sep 15, 2014
Key facts
- NPI
- 1831296334
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PP481586 (PA)
- Legal business name
- PENNSYLVANIA CVS PHARMACY LLC
- Practice address
- 402 RT 313
Perkasie, PA 18944 - Phone
- (215) 249-4750
- NPI assigned
- Sep 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Cristiana Mauricio
- Title
- MGR Phcy Enrollments
- Phone
- (401) 770-2937
Corporate family (same tax ID) 24
Member of 1
Practitioners 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA
Medicare enrollment records
| 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 |
| O20100930023265 | PA | DME Supplier - Pharmacy | 8527149566 | Practice locations: Perkasie, PA |
National Provider Directory
- Tax ID family
- Pennsylvania CVS Pharmacy LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PP481586 | PA | Yes |
Addresses
Primary practice location
402 RT 313
Perkasie, PA 18944
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3985922 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- CVS PHARMACY # 06763
Other providers in Perkasie, PA
- Shannon Nguyen
- Nirav Patel
- Pennridge Dental Arts PC
- Pennridge School District
- Pennsylvania CVS Pharmacy LLC
- Perkasie Community Ambulance
- Gabrialla Peruzzi
- Lorna L Petersen
- Joyce Ann Platz
- Liliana Esther Pompey-Cadden
All providers in Perkasie, PA · Community/Retail Pharmacy in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.