NPIMap

Organization Active NPI

Pennsylvania CVS Pharmacy, L.L.C.

  • Pharmacy
  • Greencastle, PA
National Provider Identifier
1881758415
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PP481666 Issued in PA
Legal business name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Practice address
305 W. Baltimore Street
Greencastle, PA 17225
Phone
(717) 593-0170
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Authorized official

Name
Mr. Thomas Ryan
Title
Chairman, President and Ceo
Phone
(401) 765-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PP481666 PA Primary

Addresses

Primary practice location

305 W. Baltimore Street
Greencastle, PA 17225

Mailing address

One CVS Drive
Box 1075-Pharmacy Enrollments
Woonsocket, RI 02895
Phone (401) 765-1500

Other identifiers 1

IdentifierTypeStateIssuer
3987560OtherCOMMERCIAL NUMBER

Other names 1

  • CVS Pharmacy # 00142 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080116000450 PA Part B Supplier - Mass Immunization (Roster Biller Only) 8527149566 This NPI is an additional NPI on the enrollment
O20100930079367 PA DME Supplier - Pharmacy 8527149566 Practice locations: Greencastle, PA

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 #00142305 W Baltimore St, Greencastle, PA 17225-1413(717) 593-0170 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 Dec 27, 2024

National Provider Directory

National Provider Directory
Tax ID family
Pennsylvania CVS Pharmacy LLC431 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.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1881758415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE CVS DRIVE",
            "address_2": "BOX 1075-PHARMACY ENROLLMENTS",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "02895",
            "telephone_number": "401-765-1500",
            "fax_number": "401-770-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W. BALTIMORE STREET",
            "city": "GREENCASTLE",
            "state": "PA",
            "postal_code": "17225",
            "telephone_number": "717-593-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSYLVANIA CVS PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CHAIRMAN, PRESIDENT AND CEO",
        "authorized_official_telephone_number": "401-765-1500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP481666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL NUMBER",
            "identifier": "3987560",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy # 00142",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greencastle, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.