Provider Demographics
NPI:1508960485
Name:ALABAMA CVS PHARMACY, L.L.C.
Entity Type:Organization
Organization Name:ALABAMA CVS PHARMACY, L.L.C.
Other - Org Name:CVS PHARMACY #01806
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXEC DIRECTOR, RX SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:COLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-770-2751
Mailing Address - Street 1:1 CVS DR
Mailing Address - Street 2:BOX 1075
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-6146
Mailing Address - Country:US
Mailing Address - Phone:401-765-1500
Mailing Address - Fax:
Practice Address - Street 1:1300 S MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1723
Practice Address - Country:US
Practice Address - Phone:251-943-6614
Practice Address - Fax:251-943-6615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X
AL112547333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1508960485Medicaid
0132427OtherOTHER ID NUMBER-COMMERCIAL NUMBER
AL1508960485OtherAL MEDICAID DME #
P00754161OtherMEDICARE RR
AL1508960485Medicaid
5613080123Medicare NSC