Provider Demographics
NPI:1922541143
Name:CVS PHARMACY
Entity Type:Organization
Organization Name:CVS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AGRON
Authorized Official - Middle Name:
Authorized Official - Last Name:ISMAILI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:203-297-5246
Mailing Address - Street 1:35 PADANARAM RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-3701
Mailing Address - Country:US
Mailing Address - Phone:203-730-4870
Mailing Address - Fax:203-730-4876
Practice Address - Street 1:35 PADANARAM RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-3701
Practice Address - Country:US
Practice Address - Phone:203-730-4870
Practice Address - Fax:203-730-4876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-19
Last Update Date:2016-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility