PENNSYLVANIA CVS PHARMACY, LLC (NPI# 1790105104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790105104 |
| Entity Type | Organization |
| Organization Name | PENNSYLVANIA CVS PHARMACY, LLC |
| Other Organization Name | CVS PHARMACY # 02170 |
| Practice Address |
3331 Grant Ave Philadelphia PA 19114-2629 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 2154642636 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2015-03-11 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR, PAYER RELATIONS) |
| 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 | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1015538870438 | 05 | |
| PA | NCPDP | 6000448 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY # 02170 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033761788 | Pennsylvania Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 490 N. Broad Street Suite 100, Philadelphia, PA 19130-4312 | 2019-07-12 |
| 1407203995 | Pennsylvania Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 749 N Krocks Rd, Allentown, PA 18106-9076 | 2016-05-16 |
| 1134576622 | Pennsylvania Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 1122 Chestnut St # 38, Philadelphia, PA 19107-4802 | 2016-05-16 |
| 1104271667 | Pennsylvania Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 1919 Market St, Suite 150, Philadelphia, PA 19103-1491 | 2016-05-03 |
| 1962842674 | Pennsylvania Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 3373 E Lincoln Hwy, Parkesburg, PA 19365-2111 | 2013-06-26 |
| 1710325055 | Pennsylvania Cvs Pharmacy, LLC | Pharmacy | 3265 County Line Rd, Chalfont, PA 18914 | 2013-06-10 |
| 1639273410 | Pennsylvania Cvs Pharmacy, LLC | Pharmacy | 2020 Columbia Ave # 1, Lancaster, PA 17603-4331 | 2006-09-12 |
| Street Address |
3331 GRANT AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19114-2629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029906 | Phuoc Nguyen | Nurse Anesthetist, Certified Registered | Jefferson Torresdale Hospital, 10800 Knights Rd, Philadelphia, PA 19114 | 2020-10-05 |
| 1053921932 | Priyanka Patel | Dentist | Philadelphia Dental Smiles, 9140 Academy Road, Philadelphia, PA 19114 | 2020-08-05 |
| 1215419080 | Thomas Patrick Gallagher | Specialist/Technologist | 2708 Ruth Way, Philadelphia, PA 19114 | 2018-08-29 |
| 1558840223 | Alexis Wenger | Early Intervention Provider Agency | 3810 Aubrey Ave, Phila, PA 19114 | 2018-08-13 |
| 1245759232 | Newlands Health | Clinic/Center | 9625 Frankford Ave., Philadelphia, PA 19114 | 2017-09-12 |
| 1619491453 | Nazareth Physician Services Inc | Social Worker | 9815 Roosevelt Blvd Ste G, Philadelphia, PA 19114 | 2017-08-02 |
| 1326561606 | L.s. Share & Love Support Coordinating Agency, LLC | Case Management | 3600 Red Lion Road, Apt 68c, Philadelphia, PA 19114 | 2017-07-19 |
| 1760911952 | Charles C Richards II | Counselor | 2555 Welsh Rd, Apt 407, Philadelphia, PA 19114 | 2017-06-09 |
| 1801338686 | April Neuls | Physical Therapy Assistant | 4213 Lackland Place, Philadelphia, PA 19114 | 2016-11-10 |
| 1114317583 | Siji Cyriac | Physical Therapist | 9501 State Road, Philadelphia, PA 19114 | 2015-01-23 |
| Find all providers in zip 19114 | ||||
| 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 |
|---|---|---|---|---|
| 1912536517 | Hsjc LLC | Pharmacy | 4165 N Franklin St, Philadelphia, PA 19140-2207 | 2020-04-06 |
| 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 |
| 1346883451 | Dragon Pharmacy 99, LLC | Pharmacy | 2842 Saint Vincent St Unit A2, Philadelphia, PA 19149-1454 | 2019-10-21 |
| 1609417070 | Sdarbouze Apothecary Inc. | Pharmacy | 5751 N Broad St Ste 3, Philadelphia, PA 19141-2302 | 2019-10-07 |
| 1912550575 | Shwartz Rx 5610 Inc. | Pharmacy | 5610 Lancaster Ave Ste 200, Philadelphia, PA 19131-3440 | 2019-07-22 |
| 1487112405 | Sunray Chester LLC | Pharmacy | 5518 Chester Ave, Philadelphia, PA 19143-5328 | 2019-03-08 |
| 1669954210 | Wellmart Pharmacy Inc. | Pharmacy | 2363 E Allegheny Ave, Philadelphia, PA 19134-4431 | 2018-08-30 |
| 1902383185 | Tb Pharmacy Inc. | Pharmacy | 4931 N Broad St, Philadelphia, PA 19141-2215 | 2018-07-20 |
| 1154827103 | Gilead Pharmacy Inc | Pharmacy | 1226 N 52nd St Fl 1, Philadelphia, PA 19131-4315 | 2018-03-30 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19114 |
Please comment or provide details below to improve the information on PENNSYLVANIA CVS PHARMACY, LLC.
| 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.