Provider Demographics
NPI:1922453026
Name:CVS PHARMACY
Entity Type:Organization
Organization Name:CVS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:Z
Authorized Official - Last Name:KASSABIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-443-0363
Mailing Address - Street 1:31011 VIA ESTENAGA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-2931
Mailing Address - Country:US
Mailing Address - Phone:949-443-0363
Mailing Address - Fax:
Practice Address - Street 1:30261 GOLDEN LANTERN
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-5979
Practice Address - Country:US
Practice Address - Phone:949-363-0482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA583223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy