|Provider Name||CVS PHARMACY #05983 (ARIZONA CVS STORES, L.L.C.)|
|Provider Location Address||3025 N. WINDSONG DRIVE PRESCOTT VALLEY, AZ 86314|
|Provider Mailing Address||1 CVS DR BOX 1075 - PHARMACY ENROLLMENTS WOONSOCKET, RI 02895|
|NPI Entity Type||Organization|
|Is Sole Proprietor?||N/A|
|Is Organization Subpart?||No|
|Other Organization Name||CVS PHARMACY #05983|
|Other Name Type||Doing Business As (3)|
|Last Update Date||08-23-2010|
CVS PHARMACY #05983
3025 N. WINDSONG DRIVE
PRESCOTT VALLEY, AZ
Phone: (928) 772-1613
CVS PHARMACY #05983
1 CVS DR
BOX 1075 - PHARMACY ENROLLMENTS
Phone: (401) 765-1500
Fax: (401) 770-7108
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
|No.||Taxonomy Code||Type||Classification||Specialization||License No.||State||Primary|
|1||332B00000X||Suppliers||Durable Medical Equipment & Medical Supplies||No|
Taxonomy Description: a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
Taxonomy Description: a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
|Identifier||Type / Code||Identifier State|
|5722810058||MEDICARE NSC (07)|
|Z138401||MEDICARE PIN (08)|
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
The 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.
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
The code describing the type of health care provider that is being assigned an NPI.
The entity type 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 (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization 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 Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.