Cvs Pharmacy #05535

LBN: Wisconsin Cvs Pharmacy Llc
Cvs Pharmacy #05535 is an health care organization with primary practice located at 605 W. Cottage Grove Rd. , Cottage Grove WI 53527-9222. 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 (608) 839-3704, or through Colbert, Susan F. via phone (401) 770-2751.

Contact Information

Primary practice address
605 W. Cottage Grove Rd. Cottage Grove WI 53527-9222
Phone: (608) 839-3704
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Colbert, Susan F.
Phone: (401) 770-2751

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1952678591
LBN Legal business name Wisconsin Cvs Pharmacy Llc
DBA Doing business as Cvs Pharmacy #05535
Authorized official Colbert, Susan F.
Entity Organization
Organization subpart 1 No
Enumeration date Nov 28th, 2011
Last updated Mar 7th, 2014 - about 10 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952678591 NPPES
Wisconsin Other 9102-42 PHARMACY STATE LICENSE
Wisconsin Other 5132903 PHARMACY STATE LICENSE
Wisconsin MEDICAID 1952678591 PHARMACY STATE LICENSE

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