Cvs Pharmacy # 10419
LBN: Wisconsin Cvs Pharmacy, L.L.C.
Cvs Pharmacy # 10419 is an health care organization with primary practice located at 1407 Egg Harbor Rd , Sturgeon Bay WI 54235-1239. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty.
Wisconsin Cvs Pharmacy, L.L.C. can be contacted via phone (920) 743-6089, or through Colbert, Susan via phone (401) 765-1500.
Contact Information
Primary practice address
1407 Egg Harbor Rd
Sturgeon Bay WI 54235-1239
Phone: (920) 743-6089
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | Wisconsin | |
| Suppliers / Pharmacy | 333600000X | Wisconsin | |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | Wisconsin |
Profile Details
| NPI number | 1043625924 |
|---|---|
| LBN Legal business name | Wisconsin Cvs Pharmacy, L.L.C. |
| DBA Doing business as | Cvs Pharmacy # 10419 |
| Authorized official | Colbert, Susan |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 30th, 2014 |
| Last updated | Jan 19th, 2023 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043625924 | NPPES |
| Wisconsin | Other | 5134402 | NCPDP |
| Wisconsin | MEDICAID | 100041480 | NCPDP |
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