NPIMap

Organization Active NPI

Oregon CVS Pharmacy LLC

  • Pharmacy
  • Aloha, OR
National Provider Identifier
1972718260
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
OREGON CVS PHARMACY LLC
Doing business as
CVS Pharmacy #11669
RITE AID PHARMACY 04064
Practice address
17495 Southwest Farmington Road
Aloha, OR 97007-3212
Phone
(503) 848-7700
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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, Payer Relations
Phone
(401) 765-1500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X NPA0008012 OR

Addresses

Primary practice location

17495 Southwest Farmington Road
Aloha, OR 97007-3212

Mailing address

1 CVS Dr
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other names 2

  • CVS Pharmacy #11669 Doing business as
  • RITE AID PHARMACY 04064 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20110107000453 OR Part B Supplier - Mass Immunization (Roster Biller Only) 7719979095 This NPI is an additional NPI on the enrollment
O20170104001867 OR Part B Supplier - Mass Immunization (Roster Biller Only) 3476841768 40 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Salem, OR; Sherwood, OR; Springfield, OR; Tigard, OR; Wilsonville, OR; Albany, OR; Beaverton, OR…
O20251203004251 OR DME Supplier - Pharmacy 3476841768 Practice locations: Aloha, OR

Other NPIs on the same Medicare enrollment 36

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 36

National Provider Directory

National Provider Directory
Tax ID family
CVS Pharmacy 1115036 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1972718260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "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": "17495 SOUTHWEST FARMINGTON ROAD",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970073212",
            "telephone_number": "503-848-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
        "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": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "NPA0008012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #11669",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RITE AID PHARMACY 04064",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aloha, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.