Active NPI
CVS Pharmacy Inc
Doing business as CVS Pharmacy #10843
- Pharmacy
- Lytle, TX
National Provider Identifier
1871787309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- CVS PHARMACY INC
- Doing business as
- CVS Pharmacy #10843
- Practice address
- 19244 McDonald St
Lytle, TX 78052-3644 - Phone
- (830) 772-3404
- NPI assigned
- Aug 28, 2007
- Last updated
- May 8, 2015
- 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
- Sr. Director, Payer Relations
- Phone
- (401) 770-2751
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
19244 McDonald St
Lytle, TX 78052-3644
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4545680 | Other | TX | NCPDP |
| 146491 | Medicaid | TX |
Other names 1
- CVS Pharmacy #10843
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090408000170 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 5092711895 | This NPI is an additional NPI on the enrollment |
| O20150428000708 | TX | DME Supplier - Pharmacy | 5092711895 | Practice locations: Lytle, TX |
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.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2282098 | CVS Pharmacy, Inc Dba CVS/Pharmacy #10843 | Certificate of waiver | May 15, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #10843 | 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 |
National Provider Directory
National Provider Directory- Tax ID family
- CVS Pharmacy Inc
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.
Locations
9014 N State Highway 16
Poteet, TX 78065
Phone (830) 276-0299
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Killeen, TX
- NPI 1134729379
-
- Pharmacist
- Lytle, TX
- NPI 1235734484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188259200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1431043200000",
"number": "1871787309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "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": "19244 MCDONALD ST",
"city": "LYTLE",
"state": "TX",
"postal_code": "780523644",
"telephone_number": "830-772-3404"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CVS PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-28",
"last_updated": "2015-05-08",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
"authorized_official_telephone_number": "401-770-2751"
},
"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": "NCPDP",
"identifier": "4545680",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "146491",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy #10843",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lytle, TX
- Angela Kay Collins, SLP
- Richard Costilla
- Country Breeze Counseling Center, LLC
- CRS Healthcare, LLC Dba Country Life Assisted Living (Country Life Assisted Living)
- CRW Healthcare, LLC (Country Compassion Hospice)
- Dr. Marvin Sanchez, DPM, Podiatric Medicine
- Rosemary Eldrige, LMSW
- Kendall Nicole Escobar, CSFA
- Derek Madison Ethridge, RPH
- Sandra Kay Fleming, LPCS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.