PENNSYLVANIA CVS PHARMACY, L.L.C. (NPI# 1104920958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104920958 |
| Entity Type | Organization |
| Organization Name | PENNSYLVANIA CVS PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY #02000 |
| Practice Address |
3601 Chichester Ave Ste 105 Boothwyn PA 19061-3149 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 6104972194 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2012-03-01 |
| Authorized Official Name | SUSAN COLBERT (DIR PHCY ENROLLMENTS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | PP415242L | PA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3972444 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #02000 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174189294 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1717 N 12th St Unit F, Philadelphia, PA 19122-2585 | 2019-05-14 |
| 1750874517 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 456 N 5th St, Philadelphia, PA 19123 | 2018-06-07 |
| 1972017671 | Pennsylvania Cvs Pharmacy, L.L.C. | Pharmacy | 141 West Lincoln Hwy, Exton, PA 19341 | 2017-11-17 |
| 1154833069 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1589 Fruitville Pike, Lancaster, PA 17601-4005 | 2017-11-01 |
| 1821513813 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2001 Pennsylvania Ave, Philadelphia, PA 19130-3823 | 2017-08-10 |
| 1497059463 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2363 Oregon Pike, Lancaster, PA 17601-4608 | 2011-01-05 |
| 1003118621 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 445 West Street Rd., Warminster, PA 18974 | 2010-12-02 |
| 1790091668 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 101 Oxford Valley Rd, Yardley, PA 19067 | 2010-08-30 |
| 1336451442 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2110 Spring Valley Rd, Lancaster, PA 17601-2427 | 2010-07-06 |
| 1730400953 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 130 Schuylkill Rd, Phoenixville, PA 19460-2232 | 2010-06-22 |
| Street Address |
3601 CHICHESTER AVE STE 105 |
| City | BOOTHWYN |
| State | PA |
| Zip Code | 19061-3149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386932010 | Ems Factory Inc | Ambulance | 1628 Huddell Avenue, Boothwyn, PA 19061 | 2011-07-15 |
| 1194928655 | Patricia Anne Wardius | Dentist | 3129 Naamans Creek Road, Boothwyn, PA 19061 | 2007-06-11 |
| 1912110438 | Critical Care Systems | Preferred Provider Organization | 3901 Columbia Avenue, Suite100, Linwood, PA 19061 | 2007-05-08 |
| 1205048790 | Diane Faith Senn | Pharmacist | 643 Conchester Highway, Boothwyn, PA 19061 | 2007-05-04 |
| 1205048709 | Nicole Marie Nelson | Speech-Language Pathologist | Naamans Creek Country Manor, 1194 Naamans Creek Road, Boothwyn, PA 19061 | 2007-05-04 |
| 1932221322 | Marcus Hook-trainer Fire Dept Station 68 Inc | Ambulance | 617 East 10 St, Marcus Hook, PA 19061 | 2007-04-04 |
| 1215059175 | Sarah Margaret Clark | Physical Therapist | 1194 Naanans Creek Rd, Boothwyn, PA 19061 | 2007-04-04 |
| 1235257783 | Julie Ramsey | Occupational Therapist | 1194 Naamans Creek Road, Boothwyn, PA 19061 | 2007-03-26 |
| 1316071293 | Nancy Elizabeth Jordan | Physical Therapist | 1531 Springmeadow Ln., Boothwyn, PA 19061 | 2007-03-15 |
| 1306979133 | Elwyn | Intermediate Care Facility, Mentally Retarded | 5240 Chichester Ave., Boothwyn, PA 19061 | 2007-03-13 |
| Find all providers in zip 19061 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811506561 | Temple Community Pharmacy | Pharmacy | 3535 N 5th Street Hwy Ste 2, Reading, PA 19605-1703 | 2020-07-29 |
| 1487262614 | Hometown Rx Services | Pharmacy | 3406 Edgmont Avenue, Suite B, Brookhaven, PA 19015 | 2020-07-14 |
| 1386269033 | San Juan Pharmacy LLC | Pharmacy | 200 W Buttonwood St, Reading, PA 19601-2603 | 2020-06-09 |
| 1831719319 | Mark Conklin | Pharmacy | 127 Greenbriar Dr, Wexford, PA 15090-7322 | 2020-04-24 |
| 1912536517 | Hsjc LLC | Pharmacy | 4165 N Franklin St, Philadelphia, PA 19140-2207 | 2020-04-06 |
| 1962036806 | Care Discount Pharmacy | Pharmacy | 5610 Derry St Ste 5, Harrisburg, PA 17111-3518 | 2020-03-01 |
| 1114564945 | Priority Care Rx LLC | Pharmacy | 127 S 5th St Ste 190, Quakertown, PA 18951-1674 | 2019-11-27 |
| 1326683707 | Vista Pharmacy LLC | Pharmacy | 938 N 8th St, Reading, PA 19604-2308 | 2019-11-09 |
| 1750926119 | Dharm Nandan LLC | Pharmacy | 3808 Morrell Ave, Philadelphia, PA 19114-1915 | 2019-11-08 |
| 1871137208 | My Philadelphia Pharmacy Inc | Pharmacy | 2901 E Thompson St, Front Store, Philadelphia, PA 19134 | 2019-10-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.