NPIMap

Organization Active NPI

New Jersey CVS Pharmacy LLC

  • Pharmacy
  • PT Pleasant Beach, NJ
National Provider Identifier
1972686038
Registry record updated Nov 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RS03815 Issued in NJ
Legal business name
NEW JERSEY CVS PHARMACY LLC
Practice address
1201 Richmond Ave # 1203
PT Pleasant Beach, NJ 08742-3051
Phone
(732) 295-0770
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2010

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

Authorized official

Name
Susan Colbert
Title
Director
Phone
(401) 765-1500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X RS03815 NJ Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

1201 Richmond Ave # 1203
PT Pleasant Beach, NJ 08742-3051

Mailing address

1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146

Other identifiers 1

IdentifierTypeStateIssuer
3127621OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • CVS PHARMACY 00815 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100830000881 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 2365566288 This NPI is an additional NPI on the enrollment
O20100930023856 NJ DME Supplier - Pharmacy 3678777851 Practice locations: Point Pleasant Beach, NJ

National Provider Directory

National Provider Directory
Tax ID family
New Jersey CVS Pharmacy LLC336 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1201 Richmond Ave
#1203
Pt Pleasant Beach, NJ 08742
Phone (732) 295-0770

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288656000000",
    "number": "1972686038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "PO BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 RICHMOND AVE # 1203",
            "city": "PT PLEASANT BEACH",
            "state": "NJ",
            "postal_code": "087423051",
            "telephone_number": "732-295-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2010-11-02",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "401-765-1500"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "RS03815",
            "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": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3127621",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY 00815",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in PT Pleasant Beach, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.