Provider Demographics
NPI:1598177701
Name:CVS/CAREMARK
Entity Type:Organization
Organization Name:CVS/CAREMARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DONG
Authorized Official - Middle Name:V
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:602-840-6500
Mailing Address - Street 1:4742 E INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-5440
Mailing Address - Country:US
Mailing Address - Phone:602-840-6500
Mailing Address - Fax:602-840-9522
Practice Address - Street 1:4742 E INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-5440
Practice Address - Country:US
Practice Address - Phone:602-840-6500
Practice Address - Fax:602-840-9522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty