NPI Record of CVS PHARMACY #00273 (CVS STATE CAPITAL, L.L.C.) NPI 1003004938

Pharmacy in Lewiston, ME

Complete NPI Record

Field Name Value Definition
NPI1003004938The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NameCVS STATE CAPITAL, L.L.C.The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization NameCVS PHARMACY #00273Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address1 CVS DRThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing AddressBOX 1075--PHARMACY ENROLLMENTSThe second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City NameWOONSOCKETThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameRIThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code028956146The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number4017651500The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number4017707108The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address446 SABATTUS STThe first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLEWISTONThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMEThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code04240The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number2077833784The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date10/4/2007The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date2/13/2013The date that a record was last updated or changed.
Authorized Official Last NameCOLBERTThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameSUSANThe first name of the authorized official.
Authorized Official Title or PositionDIRECTORThe title or position of the authorized official.
Authorized Official Telephone Number4017651500The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1332B00000XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1N
Healthcare Provider Taxonomy Code 23336C0003X
Healthcare Provider Primary Taxonomy Switch 2N
Healthcare Provider Taxonomy Code 3333600000X
Healthcare Provider Primary Taxonomy Switch 3Y
Other Provider Identifier 1157010001Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 105Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1ME
Other Provider Identifier 22008159Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 201Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 2NCPDP
Is Organization SubpartN