Arizona CVS Stores LLC
Organization Active NPI Pharmacy · Apache Junction, AZ
NPI 1871539924 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1871539924
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- ARIZONA CVS STORES LLC
- Practice address
- 325 W Apache Trail
Apache Junction
Apache Junction, AZ 85120-3954 - Phone
- (480) 983-1129
- NPI assigned
- Jun 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan F Colbert
- Title
- Director Pharmacy Enrollments
- Phone
- (401) 770-2751
Corporate family (same tax ID) 21
Member of 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D2285406 | Arizona CVS Stores, LLC Dba CVS/Pharmacy | Certificate of waiver | Jul 10, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #09293 |
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 assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100107000345 | AZ | Part B Supplier - Mass Immunization (Roster Biller Only) | 6406997899 | This NPI is an additional NPI on the enrollment |
| O20100930007006 | AZ | DME Supplier - Pharmacy | 6406997899 | Practice locations: Apache Junction, AZ |
National Provider Directory
- Tax ID family
- Cvspharmacy 9293
Locations
325 W Apache Trl
#9293
Apache JCT, AZ 85120
Phone (480) 983-1129
325 W Apache Trl
Apache Junction, AZ 85120
Phone (480) 973-1129
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Yes | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
325 W Apache Trail
Apache Junction
Apache Junction, AZ 85120-3954
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0353540 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- CVS PHARMACY 09293
Other providers in Apache Junction, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.