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CVS PHARMACY #17318
NPI 1053461301
Pharmacy in Grand Prairie, TX

Active since January 11, 2007CLIA 45D2232528 · Waiver
5270 S STATE HIGHWAY 360, GRAND PRAIRIE, TX 75052(469) 348-2101 Get Directions Write a Review

NPPES record last updated: June 12, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 12, 2024, Aug 25, 2016, Jan 12, 2016 (3 updates tracked since 2016).

About Cvs Pharmacy #17318 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CVS PHARMACY #17318 (NPI 1053461301) is a healthcare organization registered as a pharmacy in Grand Prairie, Texas and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through August 14, 2027 and lists Susan Colbert, Sr. Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1053461301
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameCVS PHARMACY INC
Location Address5270 S STATE HIGHWAY 360Grand Prairie, TX 75052-8307
Mailing Address1 Cvs Dr, Box 1075Woonsocket, RI 02895-6146 · (401) 765-1500 · Fax (401) 735-1080
Phone(469) 348-2101
Organization SubpartNo
Authorized OfficialSusan ColbertSr. Director, Payer Relations · (800) 746-7287
Enumeration DateJanuary 11, 2007
Last NPPES UpdateJune 12, 20243 updates tracked since enumeration
NPPES CertifiedJune 12, 2024
✔ NPI 1053461301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X · License 30511 (TX)
5270 S STATE HIGHWAY 360, Grand Prairie, TX 75052
Open in Google Maps ↗

Other Names 1

Doing Business AsCvs Pharmacy #17318

Other Identifiers 1

Other2099924Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2232528

CVS Pharmacy, Inc Dba Cvs/Pharmacy #08345 · Grand Prairie, TX
Active · expires Aug 14, 2027
CLIA Number45D2232528
Laboratory TypePharmacy
Certificate Effective DateAugust 15, 2025
Certificate Expiration DateAugust 14, 2027
Laboratory DirectorDaisy Sarpong
Laboratory Phone(866) 389-2727
Laboratory LocationCVS Pharmacy, Inc Dba Cvs/Pharmacy #083455195 Lake Ridge Pkwy, Grand Prairie, TX 75052
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
44 services44 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
38 services38 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories CVS Pharmacy #17318 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #17318

DMEPOS supplier · Grand Prairie, TXOperated by CVS Pharmacy Inc
✔

Accepts Medicare assignment

CVS Pharmacy #17318 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20314493
Medicare Participant SinceJanuary 1, 2023
Supplier Location5270 S State Hwy 360Grand Prairie, TX 75052
Phone(469) 348-2101
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICK KEITH ROBERTS PHARM.D.
Pharmacist
5270 S STATE HIGHWAY 360
GRAND PRAIRIE, TX 75052
Dallas County (469) 348-2101
DR. DESHAWN D. FONTENOT PHARM. D.
Pharmacist
5270 S STATE HIGHWAY 360, T-2243
GRAND PRAIRIE, TX 75052
Dallas County (469) 348-2101
DR. JAMES QUY CAO O.D.
Optometrist
5270 S STATE HIGHWAY 360
GRAND PRAIRIE, TX 75052
Dallas County (972) 606-4533
MR. BAMIDELE OTUNUGA R.PH
Pharmacist
5270 S STATE HIGHWAY 360, TARGET PHARMACY (T-2243)
GRAND PRAIRIE, TX 75052
Dallas County (469) 348-2101
HANSA ANONETAPIPAT LLC
Optometrist
5270 S STATE HIGHWAY 360
GRAND PRAIRIE, TX 75052
Dallas County (972) 602-2010
KHANH QUOC LE PHARMD
Pharmacist
5270 S STATE HIGHWAY 360
GRAND PRAIRIE, TX 75052
Dallas County (469) 348-2101
ANDREA DAWN NOVOTNY PHARMD, RPH
Pharmacist
5270 S STATE HIGHWAY 360
GRAND PRAIRIE, TX 75052
Dallas County (469) 348-2101

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is CVS Pharmacy Inc's NPI number?

The NPI number for CVS Pharmacy Inc is 1053461301. It was assigned to this organization in the NPPES registry on January 11, 2007. The provider is doing business as CVS Pharmacy #17318.

Where is CVS Pharmacy Inc located?

CVS Pharmacy Inc is located at 5270 S State Highway 360, Grand Prairie, TX 75052. The listed phone number is (469) 348-2101.

What is CVS Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does CVS Pharmacy Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, CVS Pharmacy #17318 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does CVS Pharmacy Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2232528) is associated with this NPI, valid through August 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does CVS Pharmacy Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 40 other insurers list CVS Pharmacy Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for CVS Pharmacy Inc was last updated on June 12, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.