Provider Demographics
NPI:1427582691
Name:CVS HEALTH
Entity Type:Organization
Organization Name:CVS HEALTH
Other - Org Name:CVS PHARMACY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WESTLEY
Authorized Official - Middle Name:EVANS
Authorized Official - Last Name:NUNN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:678-314-5251
Mailing Address - Street 1:2402 LAKE BRANDT PL
Mailing Address - Street 2:UNIT Y
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2284
Mailing Address - Country:US
Mailing Address - Phone:336-274-0179
Mailing Address - Fax:
Practice Address - Street 1:309 E CORNWALLIS DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-5103
Practice Address - Country:US
Practice Address - Phone:336-274-0179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty