Provider Demographics
NPI:1033514492
Name:CVS PHARMACY
Entity Type:Organization
Organization Name:CVS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:POST
Authorized Official - Suffix:
Authorized Official - Credentials:BPHARM
Authorized Official - Phone:505-264-5062
Mailing Address - Street 1:511 W CORDOVA RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1843
Mailing Address - Country:US
Mailing Address - Phone:505-983-5546
Mailing Address - Fax:
Practice Address - Street 1:511 W CORDOVA RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-1843
Practice Address - Country:US
Practice Address - Phone:505-983-5546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CVS PHARMACIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM00004546302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization