Active NPI
CVS Pharmacy Inc
- Pharmacy
- Willis, TX
National Provider Identifier
1962944330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- CVS PHARMACY INC
- Practice address
- 9663 W. FM 1097
Willis, TX 77318 - Phone
- (936) 228-0204
- NPI assigned
- Nov 16, 2016
- Last updated
- Jul 10, 2017
- 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
- Phone
- (401) 765-1500
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | NU | Primary | |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
9663 W. FM 1097
Willis, TX 77318
Mailing address
Box 1075
1 CVS Dr
Woonsocket, RI 02895
Phone (401) 765-1500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5920233 | Other | TX | NCPDP |
| PH0708 | Other | TX | MASS IMM |
| 471159 | Medicaid | TX |
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 |
| O20170314001777 | TX | DME Supplier - Pharmacy | 5092711895 | Practice locations: Willis, 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 |
|---|---|---|---|
| 45D2256533 | CVS Pharmacy, Inc Dba CVS/Pharmacy #10996 | Certificate of waiver | Mar 23, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #10996 | 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 Agent for CVS RX Services 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.
-
- Pharmacy
- El Paso, TX
- NPI 1952815342
Locations
9663 FM 1097 Rd W
Willis, TX 77318
Phone (936) 228-0204
Practitioners & affiliated clinicians
Practitioners 6
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
- Willis, TX
- NPI 1245186386
-
- Pharmacist
- Willis, TX
- NPI 1295447175
-
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Willis, TX
- NPI 1144826009
-
- Pharmacist
- The Woodlands, TX
- NPI 1912621806
-
- Pharmacist
- Willis, TX
- NPI 1558084046
-
- Pharmacist
- Flushing, NY
- NPI 1720684160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479254400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1499644800000",
"number": "1962944330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOX 1075",
"address_2": "1 CVS DR",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "02895",
"telephone_number": "401-765-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9663 W. FM 1097",
"city": "WILLIS",
"state": "TX",
"postal_code": "77318",
"telephone_number": "936-228-0204"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CVS PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2016-11-16",
"last_updated": "2017-07-10",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "SR DIRECTOR",
"authorized_official_telephone_number": "401-765-1500"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "5920233",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASS IMM",
"identifier": "PH0708",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "471159",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Willis, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; 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.