Provider Demographics
NPI:1518321348
Name:CVS PHARMACY, INC.
Entity Type:Organization
Organization Name:CVS PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MACIEJ
Authorized Official - Middle Name:K
Authorized Official - Last Name:SZYMCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:PHRAMD
Authorized Official - Phone:919-274-0564
Mailing Address - Street 1:9816 PERIMETER STATION DR
Mailing Address - Street 2:APT 304
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-3334
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6750 WILKINSON BLVD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012
Practice Address - Country:US
Practice Address - Phone:704-825-6929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC237243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy