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CVS PHARMACY# 05104
NPI 1609156074
Pharmacy in Manorville, NY

Active since August 17, 2011CLIA 33D2261646 · Waiver
496 COUNTY ROAD 111, BUILDING C, MANORVILLE, NY 11949(631) 399-0324 Get Directions Write a Review

NPPES record last updated: March 8, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Cvs Pharmacy# 05104 NPPES

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

CVS PHARMACY# 05104 (NPI 1609156074) is a healthcare organization registered as a pharmacy in Manorville, New York and active in the NPI registry since August 2011. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Susan F Colbert, Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1609156074
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameCVS ALBANY LLC
Location Address496 COUNTY ROAD 111, BUILDING CManorville, NY 11949-3341
Mailing Address1 Cvs Dr, Box 1075-pharmacy EnrollmentsWoonsocket, RI 02895-6146 · (401) 765-1500
Phone(631) 399-0324
Organization SubpartNo
Authorized OfficialSusan F ColbertDirector, Payer Relations · (401) 770-2751
Enumeration DateAugust 17, 2011
Last NPPES UpdateMarch 8, 2012
✔ NPI 1609156074 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
496 COUNTY ROAD 111, Manorville, NY 11949
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Other Names 1

Doing Business AsCvs Pharmacy# 05104

Other Identifiers 4

Medicare PINA300018043
Medicare NSC4413330456
Other5803110Ncpdp
Medicaid03390214NY

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 33D2261646

CVS Pharmacy No 05104 · Manorville, NY
Active · expires Mar 26, 2027
CLIA Number33D2261646
Laboratory TypePharmacy
Certificate Effective DateJune 3, 2022
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorMr. Ray M. King
Laboratory Phone(631) 399-0324
Laboratory LocationCVS Pharmacy No 05104496 County Rd 111 - Bldg C, Manorville, NY 11949
CLIA data matches this NPI record on: Address Phone
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.
581 services580 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.
474 services474 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.
63 services63 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.
44 services44 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.
44 services44 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories CVS Pharmacy# 05104 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy# 05104

DMEPOS supplier · Manorville, NYOperated by CVS Albany LLC
⋮

Does not accept Medicare assignment

CVS Pharmacy# 05104 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20449247
Medicare Participant SinceJanuary 1, 2019
Supplier Location496 County Road 111 Bldg CManorville, NY 11949
Phone(631) 399-0324
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 9

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

PURE DENTAL OF LONG ISLAND PC
Dentist (General Practice)
496 COUNTY ROAD 111, BUILDING F
MANORVILLE, NY 11949
Suffolk County (631) 929-5855
DENISE M KARAVAS PA
Physician Assistant
496 COUNTY ROAD 111, BUILDING B
MANORVILLE, NY 11949
Suffolk County (631) 405-3200
FANG CHEN MD
Internal Medicine
496 COUNTY ROAD 111, BUILDING B
MANORVILLE, NY 11949
Suffolk County (631) 405-3200
KIMBERLY MUZZONIGRO PA
Physician Assistant
496 COUNTY ROAD 111, BUILDING B
MANORVILLE, NY 11949
Suffolk County (631) 405-3200
JESSICA PETCHONKA PA-C
Physician Assistant
496 COUNTY ROAD 111, BUILDING B
MANORVILLE, NY 11949
Suffolk County (631) 405-3200
DR. ROBERT GALLER D.O., M.P.H.
Neurological Surgery
496 COUNTY ROAD 111, BUILDING D
MANORVILLE, NY 11949
Suffolk County (631) 405-3245
MRS. ELIZABETH ANN SANDERS PA-C
Physician Assistant (Medical)
496 COUNTY ROAD 111, BUILDING B
MANORVILLE, NY 11949
Suffolk County (631) 405-3200
ROBERT DANIEL RUBIN D.O.
Pediatrics
496 COUNTY ROAD 111, BLDG B
MANORVILLE, NY 11949
Suffolk County (631) 405-3200

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 Albany LLC's NPI number?

The NPI number for CVS Albany LLC is 1609156074. It was assigned to this organization in the NPPES registry on August 17, 2011. The provider is doing business as CVS Pharmacy# 05104.

Where is CVS Albany LLC located?

CVS Albany LLC is located at 496 County Road 111 Building C, Manorville, NY 11949. The listed phone number is (631) 399-0324.

What is CVS Albany LLC's specialty?

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

Does CVS Albany LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, CVS Pharmacy# 05104 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does CVS Albany LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2261646) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does CVS Albany 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 33 other insurers list CVS Albany 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 CVS Albany LLC was last updated on March 8, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.