CVS PHARMACY #04930
NPI 1467772673
Pharmacy in Madison, WI

Q: What is Wisconsin CVS Pharmacy, L.L.C.'s NPI number?

The NPI number for Wisconsin CVS Pharmacy, L.L.C. is 1467772673. It was assigned to this organization in the NPPES registry on June 10, 2010. The provider is doing business as CVS Pharmacy #04930.

Q: What is Wisconsin CVS Pharmacy, L.L.C.'s specialty?

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

Active since June 10, 2010CLIA 52D2260460 · Waiver

2 S BEDFORD ST, MADISON, WI 53703(608) 251-6047 Get Directions Write a Review

NPPES record last updated: March 7, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Cvs Pharmacy #04930 NPPES

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

CVS PHARMACY #04930 (NPI 1467772673) is a healthcare organization registered as a pharmacy in Madison, Wisconsin and active in the NPI registry since June 2010. The organization holds a CLIA Waiver certificate valid through May 18, 2028 and lists Susan Colbert, Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1467772673

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWISCONSIN CVS PHARMACY, L.L.C.

Location Address2 S BEDFORD STMadison, WI 53703-2624

Mailing Address1 Cvs Dr, Box 1075-pharmacy EnrollmentsWoonsocket, RI 02895-6146 · (401) 765-1500

Phone(608) 251-6047

Organization SubpartNo

Authorized OfficialSusan ColbertDirector, Payer Relations · (401) 770-2751

Enumeration DateJune 10, 2010

Last NPPES UpdateMarch 7, 2014

✔ NPI 1467772673 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

2 S BEDFORD ST, Madison, WI 53703

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Other Names 1

Doing Business AsCvs Pharmacy #04930

Other Identifiers 4

Medicaid1467772673WI

Medicare NSC5742910033

Medicare PIN000054510

Other5132220Ncpdp

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 52D2260460

Wisconsin CVS Pharmacy, LLC Dba Cvs/Pharmacy #04930 · Madison, WI

Active · expires May 18, 2028

CLIA Number52D2260460

Laboratory TypePharmacy

Certificate Effective DateMay 19, 2026

Certificate Expiration DateMay 18, 2028

Laboratory DirectorKeven Narveson

Laboratory Phone(866) 389-2727

Laboratory LocationWisconsin CVS Pharmacy, LLC Dba Cvs/Pharmacy #049302 S Bradford St, Madison, WI 53703

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 3

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.

290 services290 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.

253 services253 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.

31 services31 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories CVS Pharmacy #04930 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #04930

DMEPOS supplier · Madison, WIOperated by Wisconsin CVS Pharmacy LLC

✔

Accepts Medicare assignment

CVS Pharmacy #04930 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)20319113

Medicare Participant SinceJanuary 1, 2023

Supplier Location2 S Bedford StMadison, WI 53703

Phone(608) 251-6047

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.

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Other Providers at the Same Location NPPES 6

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

ELIZABETH HALMA PHARMD

Pharmacist