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CVS PHARMACY #16802
NPI 1407878283
Pharmacy in Fayetteville, AR

Active since July 24, 2006CLIA 04D2216511 · Waiver
3545 N SHILOH DR, FAYETTEVILLE, AR 72703(479) 443-5628(479) 439-6363 Get Directions Write a Review

NPPES record last updated: August 29, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 29, 2016, Aug 25, 2016, Jan 19, 2016 (3 updates tracked since 2016).

About Cvs Pharmacy #16802 NPPES

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

CVS PHARMACY #16802 (NPI 1407878283) is a healthcare organization registered as a pharmacy in Fayetteville, Arkansas and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through March 11, 2027 and lists Susan Colbert, Sr. Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1407878283
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameARKANSAS CVS PHARMACY LLC
Location Address3545 N SHILOH DRFayetteville, AR 72703-5359
Mailing Address1 Cvs Dr, Box 1075Woonsocket, RI 02895-6146 · (401) 765-1500
Phone(479) 443-5628
Fax(479) 439-6363
Organization SubpartNo
Authorized OfficialSusan ColbertSr. Director, Payer Relations · (401) 770-2751
Enumeration DateJuly 24, 2006
Last NPPES UpdateAugust 29, 20163 updates tracked since enumeration
✔ NPI 1407878283 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
3545 N SHILOH DR, Fayetteville, AR 72703
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Other Names 1

Doing Business AsCvs Pharmacy #16802

Other Identifiers 2

Other1989437Pk
Medicare NSC6715340018

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 04D2216511

Cvs/Pharmacy #10409 Arkansas CVS Pharmacy, LLC · Fayetteville, AR
Active · expires Mar 11, 2027
CLIA Number04D2216511
Laboratory TypePharmacy
Certificate Effective DateMarch 12, 2025
Certificate Expiration DateMarch 11, 2027
Laboratory DirectorAmanda Giuttari
Laboratory Phone(401) 770-6431
Laboratory LocationCvs/Pharmacy #10409 Arkansas CVS Pharmacy, LLC2402 N College Avenue, Fayetteville, AR 72703
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 5

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.
62 services62 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.
40 services40 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
19 services19 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
12 services12 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
12 services12 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories CVS Pharmacy #16802 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #16802

DMEPOS supplier · Fayetteville, AROperated by Arkansas CVS Pharmacy LLC
✔

Accepts Medicare assignment

CVS Pharmacy #16802 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)20311691
Medicare Participant SinceJanuary 1, 2023
Supplier Location3545 N Shiloh DrFayetteville, AR 72703
Phone(479) 443-5628
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 8

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

ASHLYN CRAWFORD PHARMD
Pharmacist
3545 N SHILOH DR
FAYETTEVILLE, AR 72703
Washington County (479) 443-5628
DR. JESSICA CHEREE GALL PHARMD
Pharmacist
3545 N SHILOH DR
FAYETTEVILLE, AR 72703
Washington County (479) 443-5628
DR. HEATHER AINSLEY CARTER PHARMD
Pharmacist
3545 N SHILOH DR, T-1470
FAYETTEVILLE, AR 72703
Washington County (479) 443-5628
SMITH STEVEN JENKINS PHARMD
Pharmacist
3545 N SHILOH DR
FAYETTEVILLE, AR 72703
Washington County (479) 443-5628
LAUREN MACKENZIE ROMO PHARMD
Pharmacist
3545 N SHILOH DR
FAYETTEVILLE, AR 72703
Washington County (479) 443-5628
MATTHEW BRIAN JONES PHARM D
Pharmacist
3545 N SHILOH DR
FAYETTEVILLE, AR 72703
Washington County (479) 443-5628
DR. JESSICA J FARMER PHARM.D.
Pharmacist
3545 N SHILOH DR
FAYETTEVILLE, AR 72703
Washington County (479) 443-5628
DR. SHAWNDRA JONES PHARMD
Pharmacist (Pharmacotherapy)
3545 N SHILOH DR
FAYETTEVILLE, AR 72703
Washington County (479) 443-5628

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 Arkansas CVS Pharmacy LLC's NPI number?

The NPI number for Arkansas CVS Pharmacy LLC is 1407878283. It was assigned to this organization in the NPPES registry on July 24, 2006. The provider is doing business as CVS Pharmacy #16802.

Where is Arkansas CVS Pharmacy LLC located?

Arkansas CVS Pharmacy LLC is located at 3545 N Shiloh Dr, Fayetteville, AR 72703. The listed phone number is (479) 443-5628.

What is Arkansas CVS Pharmacy LLC's specialty?

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

Does Arkansas CVS Pharmacy LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, CVS Pharmacy #16802 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Arkansas CVS Pharmacy LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2216511) is associated with this NPI, valid through March 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Arkansas CVS Pharmacy LLC 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 37 other insurers list Arkansas CVS Pharmacy LLC 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 Arkansas CVS Pharmacy LLC was last updated on August 29, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.