Active NPI
Connecticut CVS Pharmacy LLC
Doing business as CVS Pharmacy #17291
- Pharmacy
- Windsor, CT
National Provider Identifier
1972685337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- CONNECTICUT CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy #17291
- Practice address
- 1075 Kennedy Rd
Windsor, CT 06095-1308 - Phone
- (860) 907-3069
- Fax
- (860) 907-3373
- NPI assigned
- Oct 19, 2006
- Last updated
- Oct 5, 2016
- 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 | PCY2070 | CT |
Addresses
Primary practice location
1075 Kennedy Rd
Windsor, CT 06095-1308
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other names 1
- CVS Pharmacy #17291
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 |
| O20160907001982 | CT | DME Supplier - Pharmacy | 7214139633 | Practice locations: Windsor, 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.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Connecticut CVS Pharmacy, L.L.C. | 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 18
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
1075 Kennedy Rd
Windsor, CT 06095
Phone (860) 907-3068
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1475625600000",
"number": "1972685337",
"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": "1075 KENNEDY RD",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060951308",
"telephone_number": "860-907-3069",
"fax_number": "860-907-3373"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONNECTICUT CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-19",
"last_updated": "2016-10-05",
"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": "CT",
"license": "PCY2070",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy #17291",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Windsor, CT
- Complete Care at Kimberly Hall South LLC
- Comprehensive Geriatric Dental Care LLC
- Carol Ann Concannon, N.P.
- Concentra Health Services, Inc. (Concentra Medical Center)
- Connal Physical Therapy Group LLC
- Connecticut CVS Pharmacy, L.L.C. (CVS Pharmacy # 01166)
- Connecticut CVS Pharmacy, L.L.C. (CVS Pharmacy # 00349)
- Connecticut Heart Physicians, Inc.
- Connecticut Periodontal & Implant Associates
- Connecticut Therapeutic Counseling LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.