Provider Demographics
NPI:1972994721
Name:CVS CAREMARK
Entity Type:Organization
Organization Name:CVS CAREMARK
Other - Org Name:CVS CAREMARK - NOVOLOGIX
Other - Org Type:Other Name
Authorized Official - Title/Position:TRADING PARTNER ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-826-2574
Mailing Address - Street 1:8300 NORMAN CENTER DR
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-1027
Mailing Address - Country:US
Mailing Address - Phone:952-826-2500
Mailing Address - Fax:
Practice Address - Street 1:8300 NORMAN CENTER DR
Practice Address - Street 2:8TH FLOOR
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-1027
Practice Address - Country:US
Practice Address - Phone:952-826-2574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization