Active NPI
Connecticut CVS Pharmacy LLC
Doing business as CVS Pharmacy #10316
- Pharmacy
- Manchester, CT
National Provider Identifier
1972072072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- CONNECTICUT CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy #10316
- Practice address
- 1221 Main St
Manchester, CT 06040 - Phone
- (860) 512-2256
- NPI assigned
- Nov 19, 2018
- Last updated
- Dec 13, 2018
- 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
- Sr. Director
- 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
1221 Main St
Manchester, CT 06040
Mailing address
1 CVS Dr # 1075
Woonsocket, RI 02895-6146
Other names 1
- CVS Pharmacy #10316
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101105000131 | CT | Part B Supplier - Mass Immunization (Roster Biller Only) | 7214139633 | This NPI is an additional NPI on the enrollment |
| O20190226001367 | CT | DME Supplier - Pharmacy | 7214139633 | Practice locations: Manchester, CT |
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 |
|---|---|---|---|
| 07D2224972 | Connecticut CVS Pharmacy, LLC | Certificate of waiver | May 17, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Connecticut CVS Pharmacy LLC | 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
- Connecticut CVS Pharmacy LL
Organizations with this tax ID in the same state 21
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.
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
- Manchester, CT
- NPI 1811592397
-
- Pharmacist
- Manchester, CT
- NPI 1689381006
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542585600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1544659200000",
"number": "1972072072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR # 1075",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 MAIN ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "06040",
"telephone_number": "860-512-2256"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONNECTICUT CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-11-19",
"last_updated": "2018-12-13",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "SR. DIRECTOR",
"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": [],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy #10316",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CVS Pharmacy #10316",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Manchester, CT
- Erin Ruth Congdon, ND
- Michele B. Conlon, M.D.
- Connecticut Cardiology Center PC
- Connecticut Center for Orthopedic Surgery, LLC
- Connecticut CVS Pharmacy LLC (CVS Pharmacy #16597)
- Connecticut CVS Pharmacy, L.L.C. (CVS Pharmacy# 04436)
- Connecticut Endodontic Associates P.C.
- Connecticut Family Dentistry, LLC
- Connecticut Gastroenterology Assoc PC
- Connecticut Natural Health Specialists
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.