Provider Demographics
NPI:1033527783
Name:CVS/PHARMACY
Entity Type:Organization
Organization Name:CVS/PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL ADMINISTRATIVE CONTACT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:CANDORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-981-6253
Mailing Address - Street 1:904 S FIFTH ST
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-3239
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:904 S FIFTH ST
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-3239
Practice Address - Country:US
Practice Address - Phone:919-563-8855
Practice Address - Fax:919-563-6156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22735183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty