| NPI | 1104920958 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-09-12 |
| Last Updated | 2012-03-01 |
| Authorized Official | Susan Colbert DIR PHCY ENROLLMENTS Phone: 4017702751 |
| Mailing Address | 1 Cvs Dr, Po Box 1075 Woonsocket, RI 02895-6146 United States 📍 View Map |
| Primary Practice Address | 3601 Chichester Ave Ste 105 Boothwyn, PA 19061-3149 United States Phone: (610) 497-2194 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | — | 3972444 | Other ID Number-Commercial Number |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 3336C0003X – Pharmacy, Community/Retail Pharmacy | — | — |
| No | 332B00000X – Durable Medical Equipment & Medical Supplies | — | — |
| Yes | 333600000X – Pharmacy | PA | PP415242L |
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About NPI 1104920958
Pennsylvania Cvs Pharmacy, L.l.c. is an organization registered in the CMS NPPES NPI Registry with NPI number 1104920958. The primary specialty listed is Pharmacy. The organization is located in Boothwyn, PA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-09-12. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1104920958?
NPI 1104920958 belongs to Pennsylvania Cvs Pharmacy, L.l.c., a Pharmacy in Boothwyn, PA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1104920958 active?
The current status of NPI 1104920958 in the NPPES registry is Active. The record was last updated on 2012-03-01.
What specialty is NPI 1104920958?
NPI 1104920958 is classified under the taxonomy Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1104920958?
You can verify NPI 1104920958 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1104920958?
The primary practice address on file for NPI 1104920958 is 3601 Chichester Ave Ste 105, Boothwyn, PA 19061-3149. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1104920958 issued?
NPI 1104920958 was first issued (enumerated) on 2006-09-12. The NPPES record was last updated on 2012-03-01.
Practice Location Map
Pennsylvania Cvs Pharmacy, L.l.c. is located at 3601 Chichester Ave Ste 105, Boothwyn, PA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Pennsylvania Cvs Pharmacy, L.l.c.. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1104920958. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy | PP415242L | PA |