Provider Demographics
NPI:1689875817
Name:CVS
Entity Type:Organization
Organization Name:CVS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOANE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:315-682-1918
Mailing Address - Street 1:105 CHERRY HL
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-2303
Mailing Address - Country:US
Mailing Address - Phone:315-445-2472
Mailing Address - Fax:315-299-3396
Practice Address - Street 1:105 CHERRY HL
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-2303
Practice Address - Country:US
Practice Address - Phone:315-445-2472
Practice Address - Fax:315-299-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty