Active NPI
Connecticut CVS Pharmacy LLC
Doing business as CVS Pharmacy # 01152
- Pharmacy
- Niantic, CT
National Provider Identifier
1871697771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 1392
- Legal business name
- CONNECTICUT CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy # 01152
- Practice address
- 60 Pennsylvania Ave
Niantic, CT 06357-3230 - Phone
- (860) 691-0380
- NPI assigned
- Sep 12, 2006
- Last updated
- Oct 27, 2014
- 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 F 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 | 1392 | CT | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
60 Pennsylvania Ave
Niantic, CT 06357-3230
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other names 1
- CVS PHARMACY # 01152
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930083658 | CT | DME Supplier - Pharmacy | 7214139633 | Practice locations: Niantic, CT |
| O20101105000131 | CT | Part B Supplier - Mass Immunization (Roster Biller Only) | 7214139633 | This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Tax ID family
- Connecticut CVS Pharmacy LL
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
60 Pennsylvania Ave
Niantic, CT 06357
Phone (860) 691-0380
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": "1414368000000",
"number": "1871697771",
"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": "60 PENNSYLVANIA AVE",
"city": "NIANTIC",
"state": "CT",
"postal_code": "063573230",
"telephone_number": "860-691-0380"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONNECTICUT CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-12",
"last_updated": "2014-10-27",
"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": "1392",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY # 01152",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Niantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.