CONNECTICUT CVS PHARMACY, L.L.C. (NPI# 1114021011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114021011 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT CVS PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY # 00288 |
| Practice Address |
839 Farmington Ave Bristol CT 06010-3922 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 8505828167 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2011-03-25 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR) |
| Authorized Official Telephone | 4017651500 |
| 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 | 0331 | CT | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0700840 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY # 00288 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982923488 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 66 High Ridge Road, Stamford, CT 06905 | 2010-05-24 |
| 1518101732 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 241 Middle Turnpike West, Manchester, CT 06040 | 2009-05-01 |
| 1487804688 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2005 Norwich New London Tpke, Uncasville, CT 06382-1369 | 2008-09-24 |
| 1497905830 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 675 Washington St, Middletown, CT 06457-2901 | 2008-09-23 |
| 1992954994 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 72 Berlin Rd., Cromwell, CT 06416 | 2008-09-15 |
| 1649429952 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 122 E Putnam Rd, Cos Cob, CT 06807-2720 | 2008-09-10 |
| 1104921956 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 20 Bank St, Granby, CT 06035 | 2006-09-14 |
| 1740385582 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 724 Queens St, Edwards Plz, Southington, CT 06489-1505 | 2006-09-14 |
| 1831294677 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 45 South Main St, Farmington Plz, Unionville, CT 06085 | 2006-09-14 |
| 1922103761 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 542 Providence Rd, Brooklyn, CT 06234-3413 | 2006-09-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | CONNECTICUT CVS PHARMACY, L.L.C. | One Cvs Drive, Woonsocket, RI 02895 |
| Street Address |
839 FARMINGTON AVE |
| City | BRISTOL |
| State | CT |
| Zip Code | 06010-3922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649892274 | Katherine Miciak | Nurse Practitioner | 839 Farmington Ave, Bristol, CT 06010-3922 | 2020-05-18 |
| 1386272045 | Josephine Nguyen | Nurse Practitioner | 839 Farmington Ave, Bristol, CT 06010-3922 | 2020-03-30 |
| 1497315956 | Jena Mitchell | Nurse Practitioner | 839 Farmington Ave, Bristol, CT 06010-3922 | 2019-06-17 |
| 1235630344 | Chantell Smith | Nurse Practitioner | 839 Farmington Ave, Bristol, CT 06010-3922 | 2018-02-23 |
| 1932621463 | Annas Al-kalak | Pharmacist | 839 Farmington Ave, Bristol, CT 06010-3922 | 2017-07-17 |
| 1427599349 | April Bontempo | Nurse Practitioner | 839 Farmington Ave, Bristol, CT 06010 | 2017-03-10 |
| 1346695152 | Shane Patrick Kelly | Pharmacist | 839 Farmington Ave, Bristol, CT 06010-3922 | 2016-04-29 |
| 1386063840 | Siama M Ramlogan | Nurse Practitioner | 839 Farmington Ave, Bristol, CT 06010 | 2014-04-14 |
| 1881944924 | Elena Valentinovna Zhakov | Nurse Practitioner | 839 Farmington Ave, Bristol, CT 06010-3922 | 2012-09-17 |
| 1295965481 | Manhouly Phouthachack | Nurse Practitioner | 839 Farmington Ave, Bristol, CT 06010-3922 | 2009-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457991309 | A New Hope Caregiving Alliance LLC | Home Health | 225 North Main Street - Suite 107, Bristol, CT 06010 | 2020-01-08 |
| 1154981777 | Georgianna Sloate Lmft, LLC | Marriage & Family Therapist | 38 Kelley Street, Bristol, CT 06010 | 2019-06-17 |
| 1962062810 | Ariel Morley | Urology | 15 Riverside Avenue, Bristol, CT 06010 | 2019-06-13 |
| 1013439488 | Theresa Rose Manolitsis | Student in an Organized Health Care Education/Training Program | 170 Pondview Lane, Bristol, CT 06010 | 2017-07-07 |
| 1588103600 | Elizabeth Anne Costello | Pharmacist | 747 Pine Street, Bristol, CT 06010 | 2017-02-22 |
| 1992157903 | Aiman Riaz | Internal Medicine | 41 Brewster Rd # 5161, Bristol, CT 06010 | 2016-07-01 |
| 1346609955 | Monika Magdalena Sullivan | Nurse Practitioner | 122 Maple Street, Bristol, CT 06010 | 2016-02-11 |
| 1346660776 | Peter Bellezza | Podiatrist | 15 Riverside Ave, Bristol, CT 06010 | 2014-04-24 |
| 1487088001 | Stephen Alexander Merwin | Social Worker | 32 Laird Drive, Bristol, CT 06010 | 2013-08-30 |
| 1215369574 | In Kyung Lee | Dentist | 1192 Farmington Ave., Bristol, CT 06010 | 2013-08-08 |
| Find all providers in zip 06010 | ||||
| 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 |
|---|---|---|---|---|
| 1922559970 | Uwp LLC | Pharmacy | 200 Rittenhouse Cir Bldg Suite3, Bristol, PA 19007-1619 | 2016-10-14 |
| 1821359282 | Pharmacy Health Services Inc | Pharmacy | 61 Pine St Ste 401, Bristol, VT 05443-1043 | 2012-06-01 |
| 1932402336 | Rw Group Inc | Pharmacy | 25 Mellen St, Bristol, CT 06010-6313 | 2010-12-08 |
| 1407088156 | Medarbor LLC | Pharmacy | 200 Rittenhouse Cir Bldg Suitee3, Bristol, PA 19007-1619 | 2009-08-13 |
| 1235201039 | Mill Street Pharmacy Inc | Pharmacy | 416 Mill St, Bristol, PA 19007-4813 | 2006-11-15 |
| 1366549974 | H. Johnson's Pharmacy, Inc | Pharmacy | 520 Bluff City Hwy, Bristol, TN 37620-4606 | 2006-09-19 |
| 1295839462 | Hardings Markets-west Inc | Pharmacy | 300 East Elkhart St, Bristol, IN 46507 | 2006-09-11 |
| 1164535506 | Price Chopper Inc | Pharmacy | 121 Farmington Ave, Bristol, CT 06010-4217 | 2006-08-17 |
| 1639112998 | Shellys Medication Services, Inc | Pharmacy | 2522 Pearl Buck Rd Unit A, Bristol, PA 19007-6809 | 2006-06-14 |
| 1760437347 | Anderson Compounding Pharmacy Inc | Pharmacy | 310 Bluff City Hwy, Bristol, TN 37620-4602 | 2006-05-23 |
| Find all providers in BRISTOL | ||||
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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.