Cvs Pharmacy #04996
LBN: Wisconsin Cvs Pharmacy Llc
Cvs Pharmacy #04996 is an health care organization with primary practice located at N83 W15550 Appleton Avenue , Menomonee Falls WI 53051. 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 Llc can be contacted via phone (262) 253-5056, or through Colbert, Susan F via phone (401) 770-2751.
Contact Information
Primary practice address
N83 W15550 Appleton Avenue
Menomonee Falls WI 53051
Phone: (262) 253-5056
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1396014908 |
|---|---|
| LBN Legal business name | Wisconsin Cvs Pharmacy Llc |
| DBA Doing business as | Cvs Pharmacy #04996 |
| Authorized official | Colbert, Susan F |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 28th, 2011 |
| Last updated | Mar 7th, 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 | 1396014908 | NPPES |
| Wisconsin | Other | 9112-42 | PHARMACY STATE LICENSE |
| Wisconsin | MEDICAID | 1396014908 | PHARMACY STATE LICENSE |
| Wisconsin | Other | 5132977 | PHARMACY STATE LICENSE |
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