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CVS PHARMACY # 04796
NPI 1093819898
Pharmacy in Providence, RI

Active since September 12, 2006CLIA 41D2256556 · Waiver
960 BROAD ST, PROVIDENCE, RI 02905(410) 461-4383 Get Directions Write a Review

NPPES record last updated: June 16, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Cvs Pharmacy # 04796 NPPES

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

CVS PHARMACY # 04796 (NPI 1093819898) is a healthcare organization registered as a pharmacy in Providence, Rhode Island and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through March 24, 2028 and lists Cristiana Mauricio, Mgr Phcy Enrollments, as its authorized official.

NPPES Registry Identity

NPI1093819898
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameRHODE ISLAND CVS PHARMACY, L.L.C.
Location Address960 BROAD STProvidence, RI 02905-1822
Mailing Address1 Cvs Dr, Po Box 1075Woonsocket, RI 02895-6146
Phone(410) 461-4383
Organization SubpartNo
Authorized OfficialCristiana MauricioMgr Phcy Enrollments · (401) 770-2937
Enumeration DateSeptember 12, 2006
Last NPPES UpdateJune 16, 2014
✔ NPI 1093819898 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in RI · PHA00332
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
960 BROAD ST, Providence, RI 02905
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Other Names 1

Doing Business AsCvs Pharmacy # 04796

Other Identifiers 4

Other4106313Other Id Number-commercial Number
Medicare NSC6013910044RI
Medicare PIN739006334
MedicaidRI 75672RI

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 41D2256556

Ri CVS Pharmacy, LLC Dba Cvs/Pharmacy #04796 · Providence, RI
Active · expires Mar 24, 2028
CLIA Number41D2256556
Laboratory TypePharmacy
Certificate Effective DateMarch 25, 2026
Certificate Expiration DateMarch 24, 2028
Laboratory DirectorAndreysi Ortiz Estevez
Laboratory Phone(866) 389-2727
Laboratory LocationRi CVS Pharmacy, LLC Dba Cvs/Pharmacy #04796960 Broad St, Providence, RI 02905
CLIA data matches this NPI record on: Address 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.
25 services25 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.
15 services15 patients

Medical Equipment Supplier Medicare DMEPOS 18

Medicare supplier enrollment and the product categories CVS Pharmacy #04796 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #04796

DMEPOS supplier · Providence, RIOperated by Rhode Island CVS Pharmacy, L.L.C.
✔

Accepts Medicare assignment

CVS Pharmacy #04796 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)20311151
Medicare Participant SinceJanuary 1, 2023
Supplier Location960 Broad StProvidence, RI 02905
Phone(401) 461-3699
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
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
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
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 4

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

LAUREN RUSSELL PHARMD
Pharmacist
960 BROAD ST
PROVIDENCE, RI 02905
Providence County (401) 461-4383
ANDY JESUS RAMIREZ PHARM D
Pharmacist
960 BROAD ST
PROVIDENCE, RI 02905
Providence County (401) 461-4383
ANDREW SCOTT KNAPP PHARMD
Pharmacist
960 BROAD ST
PROVIDENCE, RI 02905
Providence County (401) 461-4383
MRS. MAXINE WALKER RPH
Pharmacist
960 BROAD ST
PROVIDENCE, RI 02905
Providence County (401) 461-4383

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 Rhode Island CVS Pharmacy, L.L.C.'s NPI number?

The NPI number for Rhode Island CVS Pharmacy, L.L.C. is 1093819898. It was assigned to this organization in the NPPES registry on September 12, 2006. The provider is doing business as CVS Pharmacy # 04796.

Where is Rhode Island CVS Pharmacy, L.L.C. located?

Rhode Island CVS Pharmacy, L.L.C. is located at 960 Broad St, Providence, RI 02905. The listed phone number is (410) 461-4383.

What is Rhode Island CVS Pharmacy, L.L.C.'s specialty?

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

Does Rhode Island CVS Pharmacy, L.L.C. accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, CVS Pharmacy #04796 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Rhode Island CVS Pharmacy, L.L.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 41D2256556) is associated with this NPI, valid through March 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Rhode Island CVS Pharmacy, L.L.C. 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 33 other insurers list Rhode Island CVS Pharmacy, L.L.C. 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 Rhode Island CVS Pharmacy, L.L.C. was last updated on June 16, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.